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Everything You Need to Know About Strabismus

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Strabismus is a condition in which the eyes do not properly align with each other when looking at an object. With strabismus, one eye looks directly at the object while the strabismic eye faces either inward, outward, upward or downward. For some people, the misalignment happens only when looking far away. For others, the eyes are misaligned only when looking at near. Usually the disorder is present at all viewing distances.
In some cases, the strabismic eye can alternate between the right and left eyes. The misalignment can be constant or occasional.

Strabismus Signs and Symptoms

The most common sign of strabismus is a visible misalignment of the eyes.  A large and extremely noticeable misalignment is referred to as large-angle strabismus. A less obvious eye turn is called small-angle strabismus.
In most cases, double vision from strabismus is avoided because the brain learns to ignore visual input from the misaligned eye, which can lead to another eye condition called Amblyopia.  If double vision is present, various treatments are available (see below)
Strabismus can cause a significant loss in depth perception and increases the risk for eyestrain as only one eye is functionally seeing.
The condition also has psychological and social impacts as normal eye contact is disrupted. Strabismic patients report increased anxiety and awkwardness in social interactions which can lead to negative effects on self-esteem, confidence and overall happiness.


Newborn children commonly have occasional crossing eyes due to incomplete vision development. With age it begins to disappear, however, true strabismus does not go away.
An eye examination with our optometrist is the best way to diagnose strabismus. The earlier the diagnosis, the better, and more successful the outcome of a treatment plan.

What Causes Strabismus?

Each eye has 6 external muscles that control the position of the eye as well as eye movement. For good binocular vision, both neurological control and muscle function must be properly coordinated.
With strabismus, neurological and/or anatomical problems interfere with the 6 external muscles that control the eye. This problem can either develop within the muscles themselves, or in the nerve connection between the eye and the brain. Children may be born with strabismus as it can be passed down genetically.

Treatment Options

Thankfully, both surgical and non-surgical treatment options are available for patients with strabismus.

Strabismus Surgery

For many cases of strabismus, the only effective treatment option is surgery. The success rate of the surgery depends on many factors including the underlying cause of the condition, the direction of the eye turn and the magnitude of the misalignment.
The surgery is available to both children and adults. However, the earlier strabismus is treated, the more likely the affected eye(s) will experience normal vision. In extreme cases, more than one surgery may be required for complete correction.

Non-Surgical Strabismus Treatment

Non-surgical treatments exist for intermittent and small-angle strabismus. For these cases, our optometrist may recommend vision therapy, special strength glasses or prism correction in glasses as effective treatments. Vision therapy consists of an office-based therapy as well as eye exercises performed at home. Special strength glasses help the external muscles to better align the eyes together. Prism correction in glasses helps to re-direct a viewed image so double vision is eliminated.

Which Option is Right For Me?

By booking a consultation with our optometrist, they are able to diagnose strabismus and recommend appropriate treatment options.

Written by Dr. Kent Prete

An active member of the Canadian Association of Optometrists, the Alberta Association of Optometrists, and the Alberta College of Optometrists, Dr. Prete lives his passion every day when he sees his patients. Dr. Prete has spoken at over 100 professional events over the last almost 20 years. A keen educator and confident doctor, Dr. Prete is nearly as passionate about educating other eye care professionals as he is about caring for and educating his patients!
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