Strabismus (also called cross eye or lazy eye) is a disorder that caused by a lack of coordination between the eyes. Each eye looks in a different direction and does not focus simultaneously.

Childhood strabismus is much more likely to occur if one or both parents are affected. However, many cases occur without any family history of the disorder. About three percent of children are born with the condition or develop it in their early years. In children, when the two eyes fail to focus on the same image, the brain may learn to ignore the input from one eye. If this is allowed to continue untreated, the eye that the brain ignores will never see well. This loss of vision is called amblyopia.

Adult strabismus can be caused by injuries to the eye or brain, and strokes. Diabetes is also a risk factor, as are other diseases causing limited vision loss. Loss of vision in one eye from any cause will usually cause that eye to gradually turn outward (exotropia).

In addition to the uncomfortable symptoms (lack of vision in one eye, double vision, lack of depth perception, and more) which may cause problems at work and everyday activities, people with strabismus may suffer from self-esteem problems due to their appearance.

The treatment selected depends on the patient's age and specific conditions. Eye patches, prisms and eye muscle exercises can all be effective for some patients if the condition is treated early. Surgery is the best option in other cases. The procedure involves detaching one of the six muscles attached to the eye, then reattaching it to a new position. Depending on which direction the eye is misaligned, the muscles are attached in a strengthened or weakened position. In some cases, surgery on both eyes is required for best results.

Generally, once a patient develops manifest strabismus (significantly crooked eyes), there is no treatment that will perfectly straighten the eyes...the goal is to realign them as close to normal as possible. In some cases, especially with younger patients, follow up surgery is needed, sometimes many years after the initial procedure. A general anesthetic is required for children, while a local anesthetic is an option for adults. Recovery time is rapid and the patients usually resume their normal activities within a few days.

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