There are three common types of strabismus.
- Infantile esotropia is when a baby or young child has eyes that cross inward.
- Accommodative esotropia is the most common type of strabismus in children over 2 years old. One eye may turn inward (toward the nose) when focusing on a close-up or distant object.
- Exotropia. This is when one eye turns outward (away from the nose) when looking at something far away. This can happen sometimes when a child is tired, sick, or daydreaming. A child might also squint with one eye in bright sunlight.
One or more types of strabismus treatment may be recommended, depending on your child’s age and eye alignment.
Babies and very young children with an inward turning eye (esotropia) may need surgery or glasses. Strabismus surgery on the eye muscles helps align eyes properly and allows good vision to develop.
Children over 2 years old with esotropia, may be prescribed special eyeglasses to help focus and straighten the eyes. Occasionally prisms are used to help with focus as well. A prism is a clear, wedge-shaped lens that bends (refracts) light rays. A prism can be attached to eyeglasses or made as part of the lens.
Patching or blurring might be recommended to help strengthen a misaligned eye that is weaker than the other. The child is prevented from using their stronger eye by wearing an eye patch or using blurring eye drops. This forces them to use the weaker eye, helping to strengthen it over time.
Sometimes children are taught to do certain eye muscle exercises to help focus both eyes inward.
If glasses, prisms, patching or eye exercises do not help, surgery is recommended.
Surgery is often done to correct the alignment of a child’s eyes. Strabismus surgery is usually done in an outpatient surgery center. Your child will be given a general anesthesia to be fully asleep. The ophthalmologist makes a small cut in the tissue covering the eye to reach the eye muscles. The muscles are then repositioned to help the eyes point in the same direction. This may need to be done in one or both eyes. And some children may need a second surgery to align their eyes.
After surgery, most children can get back to their daily routine in about 2–3 days.
As with any surgery, there are risks with strabismus surgery. While rare, they can be serious. Your ophthalmologist will discuss these risks and benefits of surgery.
Strabismus surgery is usually a safe and effective way to treat eye misalignment. However, it does not replace eyeglasses, patching or blurring if the ophthalmologist recommends them too. Strengthening your child’s eye muscles is very important for good vision.