Causes of Adult Strabismus

Posted on June 25, 2017

Causes of Adult Strabismus

By: Jeffrey Colburn, MD

Adults can have strabismus (eye misalignment) for a variety of reasons. Many of them have had eye muscle issues since early childhood and may have even had prior eye muscle surgeries. Some may also have had a pre-existing tendency for strabismus (called a phoria) which their brains had always been able to control in the past. In either case, sometimes the brain can lose control of the eye alignment at some point later in life.

Trauma is another potential cause of strabismus. Injuries to either the eye muscles themselves or the nerves that go to them can result in eye misalignment. One example of this would be an orbital fracture where one of the walls of the eye socket is broken and can trap or damage one of the muscles or nerves. Traumatic brain injuries can also result in nerve palsies that limit eye muscle movement and cooperation.

There is also a range of medical causes for adult strabismus. Systemic diseases like diabetes mellitus, thyroid disease (like Grave’s disease), or myasthenia gravis can all affect eye muscles in their own ways. Neurologic problems like brain tumors, multiple sclerosis, and aneurisms are also important causes that your eye doctor will consider.

If you or someone you know has adult strabismus, it is worth getting it evaluated to identify the cause and see what options are available to treat it. You can start with your regular eye doctor who may refer you to an eye muscle specialist (pediatric ophthalmologists, like us!) for further evaluation and treatment. Please get seen immediately if your strabismus and resulting double vision is brand new in the last 1-2 weeks and particularly if it is associated with a severe headache, pupil abnormalities, or a newly droopy eyelid.