Overview
In strabismus the two eyes are misaligned: one may turn in, out, up or down while the other fixes on the target. In children the brain suppresses the image from the deviating eye, which prevents double vision but risks amblyopia. In adults, who cannot suppress so readily, new strabismus usually causes double vision instead.
It can be constant or intermittent, and it is not something children grow out of. Persistent misalignment after about four months of age warrants assessment.
What are the common symptoms?
- An eye that visibly turns in, out, up or down
- Double vision, particularly in adults
- Head turning or tilting to compensate
- Squinting or closing one eye in bright light
- Poor depth perception
- Eye strain and headaches
What causes it, and who is at risk?
- Imbalance in the muscles controlling eye movement
- Significant uncorrected long-sightedness, which drives an inward turn
- Family history
- Prematurity, cerebral palsy, Down syndrome
- In adults: stroke, thyroid eye disease, nerve palsy, head injury, diabetes
How is it treated?
Aims are to restore alignment, protect or recover vision in the turning eye, and where possible restore binocular vision.
- Glasses, which fully correct some inward turns caused by long-sightedness
- Patching or drops to treat any associated amblyopia
- Prism lenses to relieve double vision
- Vision therapy for convergence problems
- Surgery to reposition the eye muscles
- Botulinum toxin in selected cases
When to get seen quickly
A sudden eye turn or new double vision at any age needs urgent assessment — it can be the first sign of a stroke, an aneurysm or another neurological problem.
This page is general information, not a diagnosis. Only an eye care professional who has examined you can tell you what is actually going on.