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Strabismus is a visual condition in which the eyes are not straight and point in different directions. One eye may look straight head, while the other eye turns inward, outward, upward or downward. The misalignment may be constant or intermittent. Strabismus is a common condition among children, but it may also occur in adults.

Childhood strabismus

About 4% of all children in the United States have strabismus. The exact cause of pediatric strabismus is not fully understood. It usually occurs in healthy children. However, strabismus is also common among children with disorders that affect the brain, such as:

  • Cerebral palsy
  • Down syndrome
  • Hydrocephalus
  • Brain injury or tumors

The 2 most common types of childhood strabismus are esotropia and exotropia.

Esotropia is the condition where the eye turns inward. Young children with esotropia do not use their eyes together. In children with esotropia and farsightedness, glasses usually straighten the eyes. In children with esotropia that do not also have farsightedness, surgery is required to align the eyes.

Exotropia is the condition where the eye turns outward. Exotropia is usually intermittent in children. Although glasses or prisms may help control the outward turning eye in children, surgery is often needed.

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Adult Strabismus

Strabismus in adults is usually associated with double vision. The common causes of adult strabismus are:

  • Results of childhood strabismus
  • Stroke
  • Diabetes
  • Poorly controlled hypertension
  • Brain injury or tumors

In addition to treating the underlying causes, the double vision is initially corrected with patching one eye or prism glasses. Persistent double vision is treated with muscle surgery.


There are six eye muscles attached to the outside of eye to control the eye movement. Two muscles move the eye horizontally to the right or left. The other four muscles move it up or down or at an angle. During surgery, the ophthalmologist repositions specific eye muscles to correct the position of the eye.

Eye MusclesMost people have this surgery as an outpatient procedure in our state of the art Surgical Center. Contrary to popular misconceptions, the eyeball is never removed from the socket during the surgery. The ophthalmologist makes a small incision in the tissue covering the eye to gain access to the eye muscles. The attachment point of the appropriate muscle is then moved to a new location. This allows the surgeon to reposition the eye to a more appropriate position.

Frequently Asked Questions

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