Strabismus / Eye Misalignment (Adults)

What is strabismus?

Strabismus refers to eye misalignment where the eyes point in different directions and are not working together. Normally, the eyes work together in aiming at the same spot to provide the brain with information to create a three dimensional image and allow depth perception. Although the word strabismus most often brings to mind crossed eyes (esotropia), it also means any misalignment and includes outward wandering (exotropia) or one eye turning up or down (hypertropia or hypotropia).

At what ages does strabismus occur?

Strabismus can begin in infancy, early childhood, or even in adulthood.

Does strabismus always cause double vision (diplopia)?

When strabismus begins at a later age, double vision is the rule if vision has developed normally. Older people with a new strabismus may be unable to ignore (or suppress) an image and will see double. 

What causes strabismus in adults?

Strabismus in adulthood may be simply due to decreased control of a prior tendency for eye wandering that the brain had always controlled previously. Other causes may include head trauma, diseases that affect the nerves (such as multiple sclerosis), long-standing high blood pressure or diabetes, or aneurysms in blood vessels supplying the brain or a tumor. Since some of these rare but potential causes can be quite serious or even life-threatening, a sudden onset of double vision in adulthood should prompt an immediate eye exam.

How is strabismus treated?

Different forms of strabismus must be dealt with differently. In many cases, the solution is as easy as wearing glasses to correct farsightedness and allow the eyes to focus correctly. Accommodative esotropia is generally treated in this manner.

Infantile esotropia, on the other hand, is usually caused by problems within the muscles that move the eye. These muscles must be operated upon to align the eyes. Often times, in cases of infantile esotropia when amblyopia (lazy eye) is also involved, the amblyopia might need to be treated first before proceeding to surgery.

Another treatment for strabismus that may sometimes be appropriate include  an injection of a drug called Botox into the eye muscles. An injection of Botox into an eye muscle temporarily relaxes the muscle, allowing the opposite muscle to tighten and straighten the eye. Although the effects of the drug wear off after several weeks, the misalignment may be permanently corrected in some cases.

Read about Strabismus in Children

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