Strabismus refers to misaligned eyes. If the eyes turn inward (crossed), it is called esotropia. If the eyes turn outward, it is called exotropia. Or, one eye can be higher than the other which is called hypertropia (for the higher eye) or hypotropia (for the lower eye). Strabismus can be subtle or obvious, intermittent (occurring occasionally), or constant. It can affect one eye only or shift between the eyes.
Strabismus usually begins in infancy or childhood. Some toddlers have accommodative esotropia. Their eyes cross because they need glasses for farsightedness. But most cases of strabismus do not have a well-understood cause. It seems to develop because of a poor ability of the brain to use the eyes together, allowing them to drift. Acquired strabismus can occasionally occur because of a problem in the brain, an injury to the eye socket, or thyroid eye disease.
When young children develop strabismus, they typically have mild symptoms. They may tilt or turn their head if they can use their eyes together in that position. Or, they may close or cover one eye when it deviates, especially at first. Adults, on the other hand, have more symptoms when they develop strabismus. They can have double vision (see a second image) and may lose depth perception. At all ages, strabismus is disturbing. Studies show school children with significant strabismus have self-image problems.
Amblyopia, or lazy eye, is closely related to strabismus. Children learn to suppress double vision so effectively that the deviating eye gradually loses vision. It may be necessary to patch the good eye and wear glasses before treating the strabismus. Amblyopia does not occur when alternate eyes deviate, and adults do not develop amblyopia.
Strabismus is often treated by surgically adjusting the tension on the eye muscles. The goal of surgery is to get the eyes straight enough that the brain can develop some depth perception. Many children will develop the ability to use the eyes together following surgery. Many adults who have had strabismus for many years may also develop some ability to use the eyes together. Surgery is performed under general anesthesia. The muscle alignment can often be adjusted in adults following surgery.
Please ask Dr. Nichols if you have additional questions regarding strabismus. In addition, Children’s Eye Foundation has an excellent comprehensive guide to strabismus surgery for parents and patients.
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My first eye exam at Boulder Eye Surgeons was very thorough and informative. The technician that gave the eye exam was very friendly and explained exactly what was going on behind these blue peepers regarding my far sightedness! Dr. Keller is my favorite eye doctor and I would recommend him for any serious eye difficulty.
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Always professional - always 'top notch'. Dr. Keller and the staff are always respectful and kind. I feel that Dr. Keller is an excellent eye surgeon that I can trust.
Pre and post cataract surgery followup with BES staff was excellent. All staff members were very knowledgeable and efficient as I called several times with questions. Surgery with Dr. Cuevas was excellent and I am very happy so far with results. Dr. Cuevas was clear and transparent with answers to my post-surgery questions and spent substantial time with me pre-surgery to make sure we came up with the best solution to meet my athletic vision requirements. I highly recommend Boulder Eye Surgeons.
The professionalism of the entire staff is impressive. Dr. Nichols spent adequate time with me explaining everything thoroughly. My daughter came with me and he took the time to address her concerns and answer her questions. The Optical department is just as 5 star as the rest of the practice. I am so grateful to these people for how they are addressing my problems with my eyes which involve a complex medical condition.
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