Strabismus is a condition in which the eyes are not aligned and point in different directions. This condition affects about 4% of adults.

Strabismus may begin in childhood and persist, reoccur, or become symptomatic in adulthood. Strabismus also can result from certain medical problems. Graves’ disease (thyroid eye disease), diabetes, strokes, and trauma are some of the more common conditions that can lead to strabismus. Less common causes are diseases that affect the muscles such as myasthenia gravis, demyelinating diseases such as multiple sclerosis, or brain and orbit tumors. Occasionally strabismus can develop after eye surgery, such as cataract, retinal, or glaucoma surgery.

Adults with strabismus may have double vision, loss of depth perception, confusion between images, eye fatigue, and reading difficulty. They often experience psychological or social problems because of the condition, and they may have problems interacting with others or securing employment because of the appearance of their eyes.

Strabismus can be treated at any age. Occasionally, eye muscle exercises, prism eyeglasses, or botulinum toxin injections can improve certain types of strabismus if the misalignment is slight. Often surgery is required. Surgery is done on an outpatient basis and sometimes can be performed with a local anesthetic only. Strabismus surgery involves loosening, tightening, or repositioning the muscles to align the eyes. An adjustable suture may be used to fine-tune the end result. An ophthalmologist (Eye M.D.) can recommend treatment options.

(c) 2007 The American Academy of Ophthalmology