$Unique_ID{PAR00048}
$Pretitle{}
$Title{Medical Advice:  Crossed Eyes}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Crossed Eyes parallel pupils lazy eye vision esotropia internal
strabismus exotropia external strabismus strabismi amblyopia ex anopsia
ophthalmologist cross eyed}
$Log{}

Your Child:  A Medical Guide


Crossed Eyes


     Quick Reference

     SYMPTOMS
     - One or both eyes are turned abnormally inward toward the nose.

     HOME CARE
     - None.  See your doctor.

     PRECAUTIONS
     - If the pupils of the child's eyes are not equally black, smoothly
       round, and the same size, see your doctor.
     - If your child's eyes are not parallel, see your doctor to avoid
       development of a lazy eye.
     - All children should have their vision checked annually beginning at the
       age of four or five.


     Crossed eyes is a condition in which one or both eyes turn inward toward
the nose.  In many cases, it is caused by improper functioning of the eye
muscles.
     The eyeballs are turned in all directions by six tiny muscles that lie
within the bony socket of the eye.  These muscles keep the eyes parallel when
the child looks at a distant object (more than 20 feet away) and turn the eyes
slightly inward when they are focusing on closer objects.
     Infants learn to focus their eyes during the first three to six months of
life.  The eyes may occasionally turn in (esotropia, or internal strabismus)
or out (exotropia, or external strabismus) in relation to each other during
this learning period.  These conditions may briefly occur even up to the age
of one year and still be considered normal.  When an infant's eyes are
continuously not parallel, when they are not parallel more and more often at
any age, or when they are not parallel past the age of one, the situation is
abnormal and requires your doctor's attention.
     Although most cases of crossed eyes are caused by improper muscle
function, some are caused by a vision problem in one or both eyes.  Anything
that can cause crossed eyes can also cause the development of a "lazy eye"
(amblyopia ex anopsia).  If lazy eye is not corrected by the age of four to
six years, disuse may cause a loss of sight in that eye.

SIGNS AND SYMPTOMS

     Watch the relationship of the eyes to each other as the child focuses
near and far, looks to either side, and looks up and down.  If the eyes seem
to turn inward more than usual, consult your doctor.
     Be aware, however, that although many young children appear to have
crossed eyes, their eyes are actually straight.  Many infants and young
children have an extra skin fold at the inner corners of their eyes (alongside
the nose).  This fold of skin appears because of the tininess of the bridge of
the nose.  This extra fold allows more white of the eye to show toward the
temples than toward the nose, creating an illusion of crossed eyes.
     Straightness of the eyes is best judged by observing the position of the
highlights in both eyes (the highlights are the points where light is
reflected in the eyes).  If the highlights are in the same position in both
eyes, the eyes are parallel.

HOME CARE

     There is no home treatment except under the supervision of your doctor.

PRECAUTIONS

  -  If the pupils of your child's eyes are not equally black, smoothly round,
     and the same size, see your doctor.
  -  If your child's eyes are not parallel, see your doctor to avoid the
     development of a lazy eye.
  -  All children should have their vision checked annually beginning at the
     age of four or five.

MEDICAL TREATMENT

     Your doctor will check the eye muscles and vision and inspect the insides
of the eyeballs.  This examination can be done on any child at any age.  If
your doctor diagnoses or suspects crossed eyes, you will probably be referred
to an ophthalmologist (a physician who specializes in disorders of the eyes).
Treatment will depend on the cause.  It may include eye surgery, glasses,
placing a patch over one eye, daily use of eye drops, or eye muscle exercises
guided by a specialist.

RELATED TOPICS:  Lazy eye; Vision problems