Strabismus & Pediatrics

Individual Treatment Plans Address Misaligned Eye Conditions

Strabismus refers to misaligned eyes. If the eyes turn inward (crossed), it is called esotropia. If the eyes turn outward (wall-eyed), it is called exotropia. One eye can be higher than the other, called hypertropia (for the higher eye) or hypotropia (for the lower eye).

Strabismus can be subtle or obvious, intermittent or constant. It can affect one eye only or alternate between the eyes. Children and adults can develop strabismus.

Strabismus in Children

Children’s eyes sometimes turn inward due to an imbalance in the focusing mechanisms of the eyes.

At your child’s first exam, the ophthalmologist will assess the reason for the eye turn. Treatments for strabismus might include glasses, patching, exercises or surgery. Our specialists are trained to determine which treatment will be best for your child.

Vision development occurs in childhood. It’s important to measure the vision of each eye because the eye with strabismus can be less developed visually than the straight eye. Eye misalignment that is not treated early enough can cause reduced vision called amblyopia.

Strabismus in Adults

Adults can have strabismus that developed in childhood and recurs as an adult, or the strabismus may be a recent development.

Poor muscle control or problems with the nerves that supply the eye muscles can cause strabismus. Adults with strabismus often have double vision.

Treatment of adult strabismus involves investigating the cause, treating any underlying health issues, treating symptoms short term until the symptoms resolve, or planning treatment for a long-term solution (e.g., prism or surgery).

Strabismus Treatment

The goal of strabismus treatment is to improve eye alignment so that the eyes work together (binocular vision). Treatment addresses the underlying cause and may include eye glasses, eye exercises, prism therapy, vision therapy and/or eye muscle surgery.

If left untreated, strabismus can create problems such as amblyopia (lazy eye), diplopia (double vision) or reduced binocular vision (depth perception).

Strabismus, like many other conditions, requires an individualized treatment plan. Your doctor will assess your eye condition, develop a treatment plan with you and keep you informed as your treatment progresses. An orthoptist is a vision specialist involved with your treatment plan to provide you with the knowledge and progression of your therapy.

Strabismus Treatment Options


If your strabismus is related to focusing, then wearing glasses with the refractive correction may be the solution to the eye misalignment. In some cases, glasses can be worn with the addition of a prism to help join double vision. This can be an alternative to surgery.


Strabismus can be treated by surgically adjusting the tension on the eye muscles. The goal of surgery is to get the eyes close enough to perfectly straight that it is hard to see any residual deviation.

Surgery can be done with local anesthesia in some adults, but requires general anesthesia in children, usually as an outpatient procedure.


Another alternative is using a Botox injection into the eye muscles, which can be used to weaken specific muscles to realign the eyes. These injections use the same Botox that is used for cosmetic treatment of facial wrinkles.