Understanding Strabismus in Children: Causes, Diagnosis & Treatment

Dr Parth Shah is the principal ophthalmologist at Clarity Eye Surgeons in Canberra. He understands that when it comes to your child’s eye health, you have many questions and concerns. In this comprehensive guide, I will shed light on Strabismus in children, its causes, treatment options, and how parents can support their little ones through this journey.

What is Strabismus?

Strabismus, often referred to as “crossed eyes” or “squint” is a condition where a child’s eyes do not align properly. This misalignment can be constant or intermittent, causing one eye to turn inwards, outwards, upwards, or downwards while the other remains straight. It can affect one or both eyes.

Strabismus is common in children, and it can occur at any age. If left untreated, it can impact a child’s vision and overall development.

Causes of Strabismus

Several factors can contribute to the development of Strabismus in children:

  • Genetics: If there is a family history of Strabismus, your child may be more prone to it.
  • Refractive Errors: Conditions like long-sightedness can increase the risk.
  • Neurological Factors: Problems with the eye muscles or the brain’s control over these muscles can lead to Strabismus.

It is essential to understand that parents are not to blame for their child’s Strabismus. It is not caused by anything you did or didn’t do during pregnancy or early childhood.

Recognising Strabismus

Recognising Strabismus in your child is crucial for early intervention. Signs and symptoms may include:

  • An eye that consistently turns inwards, outwards, upwards, or downwards.
  • Squinting or closing one eye in bright sunlight.
  • Some children may adopt a head tilt or turn to compensate for their misaligned eyes. 
  • Observe your child’s eyes closely. If one eye constantly fails to follow the other, this is an indicator of Strabismus.
  • If your child frequently complains of seeing double or overlaps in their vision, especially when reading or focusing on objects up close, this could be a sign of Strabismus.

Remember, detecting Strabismus early is crucial for effective treatment, so pay close attention to any changes in your child’s eye alignment or vision.

If you notice any of these signs, it is recommended to seek an assessment.

Diagnosis and Evaluation

The diagnosis of Strabismus involves a thorough eye examination by an optometrist or ophthalmologist. This evaluation may include:

  • Visual Acuity Test: To assess how well each eye sees.
  • Cover Test: To detect eye misalignment.
  • Refraction Test: To check for focusing errors.
  • Eye Muscle Movement Assessment: To determine the extent of the misalignment.


This evaluation helps determine the type and severity of Strabismus and guides the treatment plan.

Treatment Options

The good news is that Strabismus can usuaLLy be treated effectively, and the treatment plan is tailored to each child’s unique needs. Treatment options include:

  • Eyeglasses: Correcting refractive errors with prescription glasses can sometimes improve eye alignment.
  • Patching: Covering the stronger eye with a patch to encourage the weaker eye to work harder.
  • Surgery: eye muscle surgery can align the eyes by adjusting the position or length of the eye muscles.


Here is an overview of Strabismus surgery:

  • Procedure: The surgery involves adjusting the length or position of eye muscles to re-align the eyes. It is usually performed under general anaesthesia, ensuring your child feels no pain during the procedure.
  • Recovery: After surgery, your child may experience mild discomfort, but this can usually be managed with over-the-counter pain relievers. The eyes may be red and swollen for a few days, but this typically resolves within a week or two.
  • Success Rates: The success rate of Strabismus surgery is generally high, with most children experiencing improved eye alignment.
  • Follow-Up Care: After surgery, your child will require regular follow-up appointments to monitor their progress and ensure the eyes are aligning properly. In some cases, further treatment may be needed (e.g. glasses and/or patching). 
  • Risk of Recurrence: While surgery can effectively align the eyes, there is a risk of Strabismus recurring in the future, which might necessitate additional procedures.


It is essential to discuss the best approach with your ophthalmologist, considering your child’s age and the severity of their condition.

The Importance of Early Intervention

Early intervention is crucial in managing Strabismus effectively. Untreated Strabismus can lead to:

  • Amblyopia (lazy eye), where the brain ignores input from the misaligned eye.
  • Decreased depth perception.
  • Social and self-esteem issues as children may feel self-conscious about their appearance.

Your Role as a Parent

Supporting your child through Strabismus treatment is essential. Be sure to:

  • Attend all scheduled appointments.
  • Encourage your child to wear glasses or patches as prescribed.
  • Provide a positive and understanding environment.

Conclusion

In conclusion, Strabismus is a treatable condition, and early intervention is key to success. Remember, as a parent, you are not alone in this journey. Clarity Eye Surgeons are here to support you every step of the way. 

If you suspect your child has Strabismus or have any questions, please don’t hesitate to reach out to us. 

Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra, specialising in strabismus surgery and cataract 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.

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