Pediatric Strabismus

Strabismus is an ocular misalignment in one eye compared to the other.  One eye may be higher (hypertropia), lower (hypotropia), inward (esotropia), outward (exotropia) or twisted (cyclotropia) relative to the other.

The American Academy of Pediatric Ophthalmology and Strabismus has further details.  Please see their website for further information.

ESOTROPIA:

This type of strabismus is an in-turning of one eye relative to the other.  This is the most common type of strabismus.  It can present around the time of birth through to age 3 or 4.  With some types of esotropia (accommodative esotropia), the eyes are far-sighted and glasses can correct the in-turning eyes.  Other times, the amount of far-sightedness is small, and glasses will not help relieve the in-turned eye.  In these situations, often strabismus surgery is recommended to help improve the eye alignment.

These children can also frequently develop amblyopia (poor vision in one eye compared to the other).  If this occurs, patching therapy may also be recommended.

The American Academy of Pediatric Ophthalmology and Strabismus has further details.  Please see their website for further information.

EXOTROPIA:

This type of strabismus often presents earliest in children 16 months old to approximately 3 years of age.  The eyes are often straight at times and when the child is tired, sick or exposed to bright lights, one eye drifts outward compared to the other.  The eye misalignment may occur infrequently (less than 25% of the day) or may be very frequent (almost all of the day).  After the eyes are examined, the ophthalmologist may recommend monitoring the eye drift, starting patching, glasses or strabismus surgery.  Typically, surgery is reserved for children who have “poor control” of the exotropia, meaning the eye misalignment is present more than half of the day.  This condition can recur, even after surgery.  Some ophthalmologists will recommend delaying surgery until the child is school age.

The American Academy of Pediatric Ophthalmology and Strabismus has further details.  Please see their website for further information.