Crossed Eyes: Symptoms and Treatments

If you think you or your little ones may have strabismus, or crossed eyes, be aware of the symptoms. Early diagnosis improves the prognosis.
Crossed Eyes: Symptoms and Treatments

Last update: 30 April, 2021

Crossed eyes, also known as Strabismus, is a condition that usually appears right after birth. However, the prognosis is excellent if the condition is diagnosed and treated before the age of four.

Brain plasticity is decisive in the development of vision. The brain has greater plasticity before the age of four. This is why it’s so important to detect crossed eyes early in life, as it’s the best time for full correction.

Sometimes, this problem is easy to detect. However, many other times it requires a specialized diagnosis. In most severe cases, it doesn’t only impact someone’s vision, but also their looks. Do you want to know its symptoms and treatments? Read on!

What Are Crossed Eyes?

Crossed eyes are an alteration in the alignment of the eyes. It leads to the loss of parallelism – that is, the possibility that both eyes point in the same direction when focusing on an object.

It’s common for crossed eyes to appear right at birth or pretty soon after. As stated by the American Academy of Ophthalmology, this is due to a deficiency in the functioning of the eye muscles. They fail to maintain balance and, therefore, lack eye coordination.

A man undergoing an eye exam.
Strabismus consists of a misalignment in the focus of the eyes that usually manifests from childhood.

There are times when the condition remains stable and there are no major variations in their vision. However, other times, they fail intermittently. This is mainly when a person is tired, nervous or ill. Also, it may occur when an object is at a certain distance from the line of vision.

In almost all cases, one of the eyes has greater visual acuity and can point to the forefront. The other eye is not as sharp and remains in a non-parallel position. There are several degrees of strabism that depend on the soft of deviation a person has.

Types of Crossed Eyes

In general, when an eye moves side to side, then it’s called horizontal strabismus. On the other hand, if the eyes move up or down, then it’s called vertical strabismus. Thus, Dr. Cristián Salgado highlights four types of strabismus according to the angle of deviation of the eyes (especially the non-dominant eye).

The types of strabismus are:

  • Esotropias: In this case, this involves convergent strabismus where one eye turns in towards the nose. It is “accommodative” if it occurs when the patient makes the effort to focus; and “non-accommodative” if it’s constant.
  • Exotropias: Exotropia involves divergent strabismus where one eye turns outwards. This type of strabismus usually appears later on.
  • Hypertropias: It usually affects only one eye that is directed downward.
  • Hypotropias: When one or both eyes are directed upward.

The Symptoms of Strabismus

In principle, it’s not abnormal for a newborn to occasionally cross their eyes. Despite this, by three or four months of age, the child should be able to focus on the objects they look at with perfectly aligned eyes.

A person looking up.
Crossed eyes present significant visual problems due to lack of alignment.

The common symptoms of strabismus are:

  • The eyes don’t point in the same direction after the child is four months old.
  • Both eyes focus on one point but don’t seem to be aligned.
  • Double vision in adults.

In milder cases of strabismus, a child may close one eye when there’s sunlight. They may also tilt their head to be able to hold their gaze. For this reason, an article published in 2010 by the Cuban Journal of Hygiene and Epidemiology explained that this sometimes leads to school performance problems.

It’s estimated that 25% of learning problems are due to an immaturity of the visual system.

Eventually, between 30% and 35% of people with crossed eyes lose vision in their non-dominant eye. This is known as amblyopia or lazy eye. When strabismus occurs in adulthood, it’s also common for them to have a double vision.

Crossed Eyes: Available Treatments

The goal of treatments for this condition is to prevent the non-dominant eye from losing visual acuity and for both eyes to align as best as they can. These treatments are for strengthening the eye muscles so that the deviation either decreases or disappears.

It’s common to prescribe the use of glasses and some eye exercises to strengthen the muscle. In the case of amblyopia, the indicated treatment is total occlusion. This means putting a patch on the dominant eye to force the other to increase its sharpness.

In the most severe cases, the treatment may involve surgery. This is to weaken some muscles and strengthen others by either modifying their insertion or to shorten one of them to align them. This form of treatment requires several surgeries.

Sometimes, doctors can also correct strabismus by injecting botox (botulinum toxin). According to a study endorsed by the Spanish Society of Ophthalmology, this produces a muscular relaxation and allows the eyes to align in some cases.

In case of suspicion, go to a professional

As you’ve seen, there are methods to treat strabismus. Therefore, if you suspect you or your child have this problem, go to a professional as soon as possible so that you can begin to treat it in the most appropriate way. In the consultation, the ophthalmologist will perform the appropriate tests to find a precise solution and will give you all the explanations you need.

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  • Mezquía Valera, Alina, Aguilar Valdés, Juan, Cumbá Abreu, Caridad, & Acosta Quintana, Leanne. (2010). Agudeza visual y aprendizaje escolar en estudiantes de secundaria básica del municipio Habana Vieja. Revista Cubana de Higiene y Epidemiología48(3), 264-270. Recuperado en 03 de julio de 2020, de
  • Moguel Ancheita, S, Dixon Olvera, S, Martínez Oropeza, S, & Orozco Gómez, LP. (2003). Utilidad de la toxina botulínica en el tratamiento del estrabismo en enfermedades sistémicas. Archivos de la Sociedad Española de Oftalmología78(1), 9-14. Recuperado en 03 de julio de 2020, de
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