Adult strabismus (crossed eyes) is when your eyes are not lined up properly and they point in different directions. One eye may look straight ahead while the other eye turns in, out, up, or down. The misalignment can shift from one eye to the other.
Strabismus affects vision, since both eyes must aim at the same spot together to see properly.
There Are Six Eye Muscles That Control Eye Movement
One muscle moves the eye to the right, and one muscle moves the eye to the left. The other four muscles move the eye up, down, and at an angle. In order to focus on a single image, all six eye muscles must work together.
What Causes Adult Strabismus (Crossed Eyes)?
To line up and focus both eyes on a single target, all muscles in both eyes must be balanced and working together. The brain controls these muscles. People who have strabismus usually have a problem that can affect eye muscles. Some of those problems may include:
- Health problems such as diabetes, thyroid eye disease(or TED, also known as Graves’ eye disease), Myasthenia gravis, brain tumors, or a stroke
- Accidents or head injury
- Damage to eye muscles during some kind of eye surgery
Most adults with strabismus have had it since they were children. But sometimes it starts later in life.
How Does Adult Strabismus Affect Vision?
With normal vision, both eyes aim at the same spot. The brain combines the two images from our eyes into a single, three-dimensional (3-D) image. This is how we can tell how near or far something is from us (called depth perception).
When one eye is out of alignment, two different pictures are sent to the brain. In a young child, the brain learns to ignore the image of the misaligned eye. Instead, it sees only the image from the straight or better-seeing eye. As a result, the child loses depth perception.
Adults who develop strabismus after childhood often have double vision. This is because their brains have already learned to receive images from both eyes. Their brains cannot ignore the image from the turned eye, so they see two images.
What Are the Symptoms of Adult Strabismus (Crossed Eyes)?
The most obvious symptom is having eyes that appear out of alignment. Adults with strabismus also may notice these other symptoms:
- Weakness in or around the eye, or feeling like something is pulling around your eyes.
- Vision changes, such as double vision (seeing two of one image), blurry vision, trouble reading, or a loss of depth perception.
- Constantly tilting or turning your head to see an image clearly.
Strabismus symptoms can be constant, or they can come and go.
Adult Strabismus (Crossed Eyes) Treatment
There are several ways to treat strabismus in adults.
Adult strabismus (crossed eyes) surgery
This is the most common treatment for strabismus. Surgery can improve eye alignment and help restore proper vision.
Typically, strabismus occurs when themuscles around the eyes are either too stiff or too weak. An ophthalmologist can loosen, tighten, or move certain eye muscles so that the eyes line up properly to work together. More than one surgery may be needed to treat strabismus.
Surgery is usually done as outpatient surgery in a hospital or surgery center, using either general or local anesthesia. Your 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. After strabismus surgery, you can get back to your daily routine within a few days.
Eye muscle exercises
An ophthalmologist can teach you exercises to help you focus both eyes inward. These exercises can help if you have “convergence insufficiency.” That is when your eyes do not align properly for close tasks, like reading or computer work.
Prism eyeglasses
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. Prisms can help some people with mild double vision see one image, not two.
Botulinum toxin (Botox®)
In some cases,an injection (shot) of this drug in the eye muscles can help treat strabismus. It paralyzes the muscles that keep your eyes from aligning properly. The effect can last for just a few months, or it could permanently improve eye alignment.
It Is Never Too Late to Treat Strabismus
You do not have to live with the discomfort and problems caused by misaligned eyes. With your ophthalmologist’s help, you can find a treatment for your strabismus.
FAQs
•A condition in which eyes wander to one side, cross, or are higher or lower than the other. •Symptoms include double vision, which can start suddenly or gradually. •Treatment includes placing prisms or opaque films in eyeglasses; surgery is also an option.
Can strabismus go away on its own? ›
Strabismus usually develops in infants and young children, most often by age 3. But older children and adults can also develop the condition. People often believe that a child with strabismus will outgrow the condition. However, this is not true.
Can strabismus be cured in adults? ›
A: As an adult with strabismus, you may have been told in the past that nothing can be done. This is simply not true. In most cases, eye muscle surgery is a successful, safe, and effective treatment for strabismus in adults of all ages. The good news is that it is never too late for surgery.
What happens if strabismus is left untreated? ›
Strabismus is an intermittent or constant misalignment of an eye so that its line of vision is not pointed at the same object as the other eye. If untreated, strabismus can cause amblyopia (a decrease in vision) and permanent loss of vision.
How do you fix strabismus in adults without surgery? ›
Various treatments can help treat strabismus. Eye exercises such as pencil pushups and Brock string aim to improve eye coordination and eye-brain communication. Doctors may recommend other treatments, such as lenses, drops, and patches.
Can glasses fix a lazy eye in adults? ›
Even adults with lazy eye can often achieve better vision with treatment, so it's worth talking to your doctor about options. Treatment options for lazy eye include: corrective eyeglasses and contact lenses.
What is the root cause of strabismus? ›
Most strabismus happens because of a problem with neuromuscular control of your eye movement, which involves your brain. Less commonly, there's a problem with the actual eye muscle. Another factor is family history. About 30% of children with strabismus have a family member with a similar problem.
What happens if you don't fix strabismus? ›
Amblyopia or poor vision due to strabismus — esotropia or exotropia — that isn't corrected before age 9 will result in a permanent loss of vision.
What do people with strabismus see? ›
Adults who develop strabismus after childhood often have double vision. This is because their brains have already learned to receive images from both eyes. Their brains cannot ignore the image from the turned eye, so they see two images.
Is strabismus a disability? ›
Having a squint is not usually considered a disability unless it significantly affects how you go about day to day life. Childhood strabismus that isn't treated can lead to a lazy eye, with vision loss in the affected eye. If your vision in the other eye is good, this is unlikely to cause a disability.
Strabismus usually can be fixed when found and treated early. If it's not treated, the brain eventually will ignore the visual images of the weaker eye. This change — called amblyopia, or "lazy eye" — can make vision blurry, cause double vision, and harm a child's depth perception (seeing in 3D).
What is the success rate of strabismus surgery in adults? ›
In 2022, 68.2% of adults who underwent a single strabismus surgery were without diplopia in the primary position, and 12.1% were without diplopia in the primary position with prism glasses.
What causes sudden onset strabismus in adults? ›
Sometimes strabismus is due to a medical condition like thyroid problems, myasthenia gravis, or diabetes. Other times it happens due to eye or head trauma or because an eye doesn't see well. Often, no cause can be identified. Rarely, it is due to neurologic problems, like a tumor or aneurysm.
Is strabismus a brain problem? ›
In some children, strabismus is one of several manifestations of other medical conditions, including traumatic brain injury, retinopathy of prematurity, retinoblastoma, cerebral palsy and others.
Does strabismus get worse with age? ›
Outpatient surgical correction is often the best option for adults with strabismus. The condition is only likely to worsen as a result of the aging process.
What is the main cause of strabismus? ›
Most strabismus happens because of a problem with neuromuscular control of your eye movement, which involves your brain. Less commonly, there's a problem with the actual eye muscle. Another factor is family history. About 30% of children with strabismus have a family member with a similar problem.
What does vision look like with strabismus? ›
Adults with strabismus also may notice these other symptoms: Weakness in or around the eye, or feeling like something is pulling around your eyes. Vision changes, such as double vision (seeing two of one image), blurry vision, trouble reading, or a loss of depth perception.
How do you get rid of strabismus? ›
The most common treatments for strabismus are:
- Glasses. Wearing glasses can sometimes correct mild strabismus.
- A temporary eye patch over the stronger eye if your child has amblyopia. This can make the weak eye stronger, which may help align the eyes. ...
- Surgery on the eye muscles.
Visual impairments can be caused by eye conditions like amblyopia (“lazy eye”) or strabismus (misaligned or crossed eyes), eye or brain injuries, or birth defects. In school, kids may: not be able to see objects at a distance, like on a whiteboard or blackboard.
