Understanding Hypotropia: Causes, Symptoms and Treatment Options

What is Hypotropia?

Hypotropia is a form of strabismus, commonly known as “lazy eye” or “squint”, where one eye deviates downward in relation to the other. This misalignment can occur constantly or intermittently and may affect one or both eyes. While it can occur at any age, it often becomes noticeable in childhood.

Causes of Hypotropia

  1. Muscle Imbalance: Disproportionate strength or weakness in the muscles that control eye movement can lead to hypotropia.

  2. Nerve Damage: Trauma, neurological conditions, or congenital abnormalities affecting the nerves responsible for eye movement can result in hypotropia.

  3. Congenital Factors: Some individuals may be born with an inherent predisposition to developing hypotropia due to genetic factors or structural abnormalities in the eye.

Symptoms of Hypotropia

  1. Visible Eye Misalignment: One eye appears lower than the other, leading to an asymmetrical appearance.

  2. Diplopia (Double Vision): Seeing two images instead of one, which can cause confusion and discomfort.

  3. Head Tilting: Patients may tilt or turn their head to alleviate double vision and improve visual alignment.

  4. Difficulty with Depth Perception: Impaired depth perception and coordination, especially in activities requiring binocular vision such as sports or driving.

  5. Eyestrain and Fatigue: Individuals struggling to focus or maintain alignment can experience eye strain and fatigue, particularly after prolonged visual tasks.

Treatment Options for Hypotropia

  1. Glasses or Contact Lenses: In some cases, prescription glasses or contact lenses may help alleviate symptoms by correcting refractive errors and promoting better visual alignment.

  2. Eye Exercises: Specialised exercises and activities designed to improve eye coordination and strengthen weak muscles can be beneficial.

  3. Prism Lenses: Prism lenses can be incorporated into glasses to alter the path of light entering the eye, reducing double vision.

  4. Eye Muscle (strabismus) Surgery: Strabismus surgery may be recommended to adjust the positioning of the eye muscles and restore proper alignment.


Hypotropia can significantly impact visual function and overall quality of life, but with early detection and appropriate intervention, it can be manageable.

If you or your loved one are experiencing symptoms of hypotropia, contact us to seek professional evaluation and treatment. At Clarity Eye Surgeons, we’re dedicated to providing comprehensive care and personalised solutions to address your unique needs.

Author Bio

Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra, specialising in cataract surgery & strabismus (eye muscle) surgery. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.