Skip Ribbon Commands
Skip to main content
Skip Navigation LinksBoys Town National Research Hospital > Knowledge Center > Articles > Pediatric Ophthalmology > Cross Eye (Strabismus)

 Cross Eye (Strabismus)

Strabismus, more commonly known as cross-eyed, is a condition in which an individual has difficulty moving the muscles in the eye, resulting in one or both eyes pointing in different directions.

What Causes Strabismus?

Strabismus in children is mostly hereditary–occurring when the muscles, nerves or brain do not function properly. Other eye or head injuries and diseases like Down syndrome, can also play a factor.

The condition can also trigger Amblyopia – lazy eyes – and occurs when one or both eyes do not work together to look at an object and the brain may be paying attention to the image from only one eye and ignoring the image in the other.

Symptoms

Symptoms may vary and occur in one or both eyes and increase when your child is tired or sick.

  • Eyes turn in different directions and do not move together
  • Double vision
  • Poor depth perception
  • Shutting or squinting constantly in the outdoor light

Testing

  • Infants. With infants, a doctor may check the eyes with a small light to see if the reflection of the light is properly centered in each eye.
  • Children. With children, a doctor may cover one of the eyes and then the other to see if your child's eyes shift abnormally when focusing on a near or distant object, testing the vision and ability to follow objects with each eye. In older children, the doctor may test to see if your child's eyes can work well together by checking three-dimensional vision and any signs of diseases.

Treatment

Early treatment is crucial in helping the eye become stronger and developing normal vision. While treatment after 9 years of age may improve a child's appearance, it may not always help with vision problems. Treat as early as possible. Consult a pediatric ophthalmologist to see which option will work best. Treatment options may include:

  • Glasses or contacts. Glasses can help correct refractive errors and allow eyes to focus.
  • Patching or Prescription Eye Drops. Both can be used on the stronger eye and helps the brain to pay attention to the weaker eye and helps the eye to develop more normally.
  • Surgery on Eye Muscles. Eyes that are not aligned normally interfere with the ability to communicate through eye contact and affect the ability to judge distance and depth. Muscles may be loosened, tightened or repositioned during surgery. More than one surgery may be needed to ensure the alignment and coordination between the eyes and brain. 
  • Patching stronger eyes. Patching or covering the dominant eye promotes the strengthening of the weakened eye.

Always follow the full course of treatment your physician prescribes and be sure to ask any questions you may have. How long recovery may take, when can your child return to normal activities and what risks or symptoms may occur are all questions your physician can answer.