CROSSED EYES / OUTWARD TURNING EYE / LAZY EYE

Crossed eyes and outward turning eye are eye problems belonging to the same group of eye conditions called misaligned eyes or strabismus. Misaligned eyes are fairly common in children. With misaligned eyes, one eye usually looks straight ahead and the other eye may turn in, out, up, or down. Crossed eyes, when one or both eyes turn in, is the most common of misaligned eyes. A baby may be born with crossed eyes, or may develop them shortly after birth.

Too tight eye muscles are one of the causes of crossed eyes. Surgery, usually before age 2, can fix this problem. Often, but not always, crossed eyes may run in families. The second most common cause of crossed eyes is farsightedness. This usually occurs between ages 2 and 6.

A child may be born with outward turning eyes. It is more common for outward turning eye to develop between the ages of 2 and 7. At first, the eye may just turn out occasionally, but then it becomes more frequent. Children with outward turning eyes may squint when in bright sunlight. If the outward turning eye is very bad, eye muscle surgery may be required for this too.

With normal vision, both eyes aim at the same place. The brain takes the two like images and makes one picture that has depth perception. When one eye turns, the brain is seeing two different images and cannot make them into one. The brain learns to ignore the image from the turned eye or weaker eye. Children with a misaligned eye see only the image from the straight or better-seeing eye. Depth perception is lost.

The brain of the child with misaligned eyes learns to use just the image from the good eye. When this happens, it is called lazy eye, or amblyopia. Lazy eye happens in about half the children that have misaligned eyes. If lazy eye is detected early in life, it can usually be treated successfully. If it is not treated, the child may eventually lose vision in that eye.

If the child has misaligned eyes from farsightedness, glasses may correct the problem. Another way to treat ambylopia is to patch the good eye. This is done for about 6 hours or more a day. Another option is to put a drop in the good eye to make the vision blurry. These treatments force the lazy eye to do the work of seeing.

There are other causes for lazy eye. Other less common causes of lazy eye are cataracts or droopy eyelids.

Treatment objectives are to:

preserve vision
straighten the eyes and
restore 2-eyed vision

When an adult has one of these conditions, it is usually a carry-over from childhood. If an adult develops one of these later in life, double vision may be a first symptom. This happens because the adult brain is already trained to receive messages from both eyes. Therefore, the image from the misaligned eye cannot be ignored. Double vision may also be a sign of a more serious health condition. Any person who has double vision should see a healthcare provider for an evaluation.

All children should have an eye exam by the age of 4 years. If a problem is noticed, like squinting, or an eye that obviously turns in, an earlier eye exam should be done. Eye exams and school vision screenings are the most important factors in finding eye and vision problems in infants and children.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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