Cross-Eyes (Strabismus): Causes, Symptoms, and Treatments

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Strabismus (Cross-Eyes)


Strabismus, commonly known as cross-eyes, is a condition in which the eyes are misaligned, causing them to look in different directions. This misalignment can be inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). Strabismus affects approximately 4% of the population, with esotropia being the most common type.


The exact cause of strabismus is often unknown, but it is believed to be a combination of genetic and environmental factors. Some of the risk factors associated with strabismus include:

  • Family history: People with a family history of strabismus are more likely to develop the condition.
  • Certain medical conditions: Conditions such as cerebral palsy, Down syndrome, and muscular dystrophy can increase the risk of strabismus.
  • Premature birth: Babies born prematurely are more likely to have eye muscle imbalances, which can lead to strabismus.
  • Eye muscle problems: Weakness or imbalances in the eye muscles can cause the eyes to misalign.
  • Neurological disorders: Conditions that affect the nervous system, such as stroke or brain injury, can disrupt the nerve signals that control eye movements.


The main symptom of strabismus is the misalignment of the eyes. This can lead to a number of other symptoms, including:

  • Double vision (diplopia): When the eyes are misaligned, the brain receives two different images from the eyes, which can cause double vision.
  • Eye strain and headaches: Trying to focus with misaligned eyes can lead to eye strain and headaches.
  • Poor depth perception: Strabismus can affect depth perception, making it difficult to judge distances.
  • Reduced peripheral vision: In some cases, strabismus can cause reduced peripheral vision.
  • Cosmetic concerns: Misaligned eyes can be a source of cosmetic concern for many people.


Strabismus is diagnosed through a comprehensive eye examination performed by an eye doctor (ophthalmologist or optometrist). The exam typically includes:

  • Visual acuity test: To check for any vision problems.
  • Eye movement examination: To assess the alignment of the eyes in different directions of gaze.
  • Cover test: To evaluate the eye’s ability to maintain alignment when one eye is covered.
  • Fundus examination: To examine the back of the eye for any underlying issues.


The treatment for strabismus depends on the underlying cause and the severity of the condition. Treatment options may include:

Eyeglasses or contact lenses: Corrective lenses can help improve the alignment of the eyes and reduce double vision. Eye exercises: Specific eye exercises can help strengthen the eye muscles and improve alignment. Orthoptic training: This therapy involves using specialized equipment to improve eye coordination and alignment. Surgery: Surgery may be necessary if other treatments have not been successful in correcting the strabismus.


Early diagnosis and treatment of strabismus are crucial to prevent long-term vision problems, such as amblyopia (lazy eye). Regular eye exams are essential for monitoring the condition and adjusting treatment as needed.


If strabismus is not treated, it can lead to several complications, including:

  • Amblyopia: When the misaligned eye is suppressed by the brain, causing it to become weak and lose vision.
  • Stereopsis loss: Reduced ability to perceive depth.
  • Increased risk of eye injuries: Misaligned eyes can be more vulnerable to injuries, as they may not be able to focus on objects correctly.
  • Psychological and social difficulties: Strabismus can affect self-esteem and lead to social difficulties.


Strabismus is a common eye condition that can affect people of all ages. While the exact cause is often unknown, early diagnosis and treatment are crucial to prevent long-term vision problems. Treatment options may include corrective lenses, eye exercises, orthoptic training, or surgery. Regular eye exams are essential for monitoring the condition and ensuring the best possible outcome for individuals with strabismus.

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