Strabismus (Cross Eyed)

Strabismus (Cross Eyed) · NYC Eye DoctorCrossed eyes, or strabismus, is an eye condition where both eyes aren’t looking in the same direction at the same time. Typically, strabismus occurs in people who are very farsighted or have weak eye muscle control. Strabismus is also referred to as squint or squint eye.

Your eye movement is controlled by six muscles that receive signals from your brain, telling your eye to look up, down, left and right. Your eyes typically work together so they point in the same direction at the same time. Problems arise when one or more of the six muscles aren’t functioning properly or aren’t receiving the signals to tell the eye where to turn.

The irregular eye turning of strabismus may occur all the time or only when you are ill, tired or have done a lot of reading or focused work. The same eye may irregularly turn consistently, or your eyes may alternate in abnormal turning.

Correct eye alignment is vital for seeing good depth perception. When misalignment occurs, your brain receives two different images, which can cause confusion and double vision. Over time, your brain conditions itself to ignore that abnormal vision from the turned eye. When strabismus is untreated, it can lead to permanently degraded vision in the turned eye. This condition is known as lazy eye or amblyopia.

Causes of Strabismus

Strabismus, or crossed eyes, is caused by issues with the eye muscles, the nerves that connect them to the brain or the control center of your brain that sends signals to those muscles to guide your eyes. Strabismus also can be caused by eye injuries and other health conditions in the body.

Risk factors that can lead to the development of strabismus include:

  • Refractive error: People who have severe hyperopia (farsightedness) are at risk to develop crossed eyes because of the additional eye focusing required to see clearly. Eye focusing can strain the eye muscles and cause strabismus.
  • Family history: Children of parents with strabismus are likely to develop the condition themselves.
  • Medical conditions: Those who struggle with medical conditions such as cerebral palsy or Down syndrome or those who’ve suffered a head injury or stroke are at a higher risk of developing crossed eyes.

If you are having any abnormal visual symptoms, you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

Strabismus Symptoms

The most common symptom of strabismus is when the eyes point in different directions. However, there are signs to watch for in children that may signal the development of strabismus, including:

  • Eyes that don’t move in unison
  • Angling or tilting the head to the side
  • Points of reflection in each eye aren’t symmetrical (reflections appear in different areas)
  • Squinting with one eye
  • Inability to properly gauge depth

If you are having visual abnormalities you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

Diagnosing Strabismus

Strabismus can be diagnosed through a comprehensive eye exam by an eye care professional. Here are some of the tests an ophthalmologist uses when assessing your eyes for strabismus:

  • Sharpness of vision: Your eyecare professional measures visual acuity to determine how much of your vision is being affected. This test involves reading letters on charges that are near and far. Visual acuity is described as a fraction; for example, 20/20 is “normal” vision. The first number represents the distance at which testing is done (20 feet), and the second number is the smallest letter size that can be read clearly at a distance of 20 feet. A person with 20/40 vision would have to be within 20 feet to clearly read a letter that should be readable at 40 feet.
  • Patient history: Your eye doctor asks about your past medical history. This includes general health problems, prescribed medications, environmental circumstances, and any current eye symptoms.
  • Focus and alignment testing: The doctor tests the ability of your eyes to focus, move and work in unison. This testing identifies issues that may prevent your eyes from focusing correctly or working together properly.
  • Refraction: Your ophthalmologist conducts a refraction test using an instrument called a phoropter to determine the appropriate lens power, or prescription, to compensate for nearsightedness, farsightendness or astigmatism. The phoropter holds a series of lenses in front of your eyes to measure how they focus on a retinoscope, a handheld, illuminated instrument.
  • Eye health examination: Your eye doctor uses various testing procedures to examine the structures inside and outside of your eyes, looking for any irregularities that can be a sign of a developing disease or strabismus. This exam also tests how your eyes respond under typical conditions. When testing young children or patients who can’t respond verbally, the doctor may use eye drops that temporarily prevent the eyes from changing focus during the examination.

After these and other exams, the ophthalmologist can determine if you are developing strabismus. You can then discuss treatment options if strabismus is developing or if you have other eye issues.

Treating Strabismus

Your eye doctor can offer a variety of options to treat strabismus. These may include eyeglasses, contact lenses, vision therapy, prisms, or even eye muscle surgery. If detected and treated early, crossed eyes (strabismus) can be corrected with significant positive results.

You have several treatment options to improve eye alignment and coordination. They include:

  • Eyeglasses or contact lenses: Glasses or contacts may be the only viable treatment for some patients.
  • Vision therapy: Your eye doctor may prescribe a program of activities as therapy for your vision to improve focus and coordination. This treatment also can reinforce the connection between your brain and your eyes. Vision therapy can be conducted in your home or your ophthalmologist’s office.
  • Prism lenses: These are special lenses that redirect the light entering them to reduce the amount of turning your eyes have to do to look at objects. The prism power varies depending on the prescription strength, and sometimes the prisms can eliminate eye-turning completely.
  • Eye muscle surgery: Surgery alters the form and position of the eye muscles in relation to your eye, so that your eye looks straight. People who receive eye muscle surgery also need vision therapy to retrain the eye-muscle coordination and to prevent your eyes from becoming misaligned again.

If you are having any abnormal visual symptoms, you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.


Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.

Do you have any questions about Strabismus (Cross Eyed)? Would like to schedule an appointment with the best ophthalmologist NYC or Optometrist, Dr. Saba Khodadadian of Manhattan Eye Specialists, please contact our office for consultation with NY Eye doctor.

Manhattan Eye Specialists
Dr. Saba Khodadadian, Optometrist (NYC Eye Doctor)

51 East 25th Street, Ste 401
New York, NY 10010

(Between Madison Ave & Park Ave)
(212) 533-4821

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class Optometrist or Ophthalmologist regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.