How is strabismus treated?

Treatment options include the following:

  • Eyeglasses or contact lenses: Used in patients with uncorrected refractive errors. With corrective lenses, the eyes will need less focusing effort and may remain straight.
  • Prism lenses: Special lenses that can bend light entering the eye and help reduce the amount of turning the eye must do to look at objects.
  • Orthoptics (eye exercises): May work on some types of strabismus, especially convergence insufficiency (a form of exotropia).
  • Medications: Eye drops or ointments. Also, injections of botulinum toxin type A (such as Botox) can weaken an overactive eye muscle. These treatments may be used with, or in place of, surgery, depending on the patient's situation.
  • Patching: To treat amblyopia (lazy eye), if the patient has it at the same time as strabismus. The improvement of vision may also improve control of eye misalignment.
  • Eye muscle surgery: Surgery changes the length or position of eye muscles so that the eyes are aligned correctly. This is performed under general anesthesia with dissolvable stitches. Sometimes adults are offered adjustable strabismus surgery, where the eye muscle positions are adjusted after surgery.

What can happen if strabismus is not treated?

Some believe that children will outgrow strabismus or that it will get better on its own. In truth, it can get worse if it is not treated.

If the eyes are not properly aligned, the following may result:

  • Lazy eye (amblyopia) or permanent poor vision in the turned eye. When the eyes are looking in different directions, the brain receives two images. To avoid double vision, the brain may ignore the image from the turned eye, resulting in poor vision development in that eye.
  • Blurry vision, which can affect performance in school and at work, and enjoyment of hobbies and leisure activities
  • Eye strain
  • Fatigue
  • Headaches
  • Double vision
  • Poor 3-dimensional (3-D) vision
  • Low self-esteem (from embarrassment about one’s appearance)

It is also possible that by not diagnosing strabismus, a serious problem (such as a brain tumor that is causing the condition) may be overlooked.

Last reviewed by a Cleveland Clinic medical professional on 01/22/2019.


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