There's more to healthy vision than 20/20 eyesight!

Strabismus and Amblyopia

Strabismus and amblyopia are not eye diseases but visual conditions that significantly alter the function of one's visual system and motor coordination.

What is strabismus?

Strabismus (also called crossed eyes, wall eyes, squint, tropia) is a condition where the two eyes are out of alignment and, therefore, do not look at the same object together. One eye may turn in or out, up or down. Strabismus may be constant or intermittent. Most often this condition develops early in life. However, a significant number of older children and adults develop strabismus.

What are the signs and symptoms of strabismus?

Signs of strabismus often include the following:

  • Misalignment of the eyes
  • Clumsiness, poor coordination
  • Avoidance of participation in sports
  • Difficulty with activities requiring quick visual spatial judgments like driving, catching or kicking a ball
  • Squinting, especially in bright light
  • Uneasiness in or avoidance of large spaces like malls
  • Poor eye contact

Symptoms may include one or more of the following, or perhaps none:

  • Double vision
  • Poor depth perception
  • Blurry vision
  • Clumsiness
  • Reading problems
  • Headaches, eyestrain
  • Closing or covering an eye
  • Head turn

What causes strabismus?

Strabismus can be caused by illness, trauma, stroke, developmental delays and/or genetics.

The condition leads to poor eye teaming abilities and difficulty coordinating the eyes with body movement and balance. As a result, confusion develops in the brain where the different visual images (input) cannot be matched and combined into one image.

The visual confusion can lead to double vision, disruptions in movement and interference with thinking. Once this visual confusion begins, the brain begins adapting to the condition in a variety of ways. One of the images, usually the input from the deviating eye, is partially ignored or suppressed. Then alterations in posture and movement occur in order to match the altered visual input with body movement and balance. Other adaptations include avoiding eye contact or avoiding activities that require quick visual spatial judgments.

What is amblyopia?

Amblyopia, commonly known as lazy eye, is a condition where visual information from one of the eyes is reduced because the eye and the brain are not working together properly. The condition leads to poor eye teaming abilities and difficulty coordinating the eyes with body movement and balance. As a result, confusion develops in the brain where the different visual images (input) cannot be matched and combined into one image.The visual confusion can lead to double vision, disruptions in movement and interference with thinking. Once this visual confusion begins, the brain begins adapting to the condition in a variety of ways. One of the images, usually the input from the deviating eye, is partially ignored or suppressed. If the brain suppresses the visual information long enough amblyopia results.

The visual loss in amblyopia cannot be corrected by just wearing glasses. Amblyopia affects approximately 2 to 3 out of every 100 children and is thought to develop early in life during the critical period of visual development. For many years it was thought that amblyopia was a permanent condition unless it was detected and treated before the age of six. Research supports the statement that success rates for people over the age of 16 were only slightly lower than those for young children (M. Birnbaum).

What are the signs and symptoms of amblyopia?

Signs of amblyopia often include the following:

  • Misalignment of the eyes
  • Clumsiness, poor coordination
  • Avoidance of participation in sports
  • Difficulty with activities requiring quick visual spatial judgments like driving, catching or kicking a ball
  • Squinting, especially in bright light
  • Uneasiness in or avoidance of large spaces like malls
  • Poor eye contact

Symptoms may include one or more of the following, or perhaps none:

  • Double vision
  • Poor depth perception
  • Blurry vision
  • Clumsiness
  • Reading problems
  • Headaches, eyestrain
  • Closing or covering an eye
  • Head turn

What causes amblyopia?

Amblyopia may be caused by any condition that affects normal visual development or use of the eyes. Strabismus, which is a condition where the two eyes are out of alignment, is the most common cause of amblyopia. Other causes of amblyopia include childhood cataracts, refractive conditions such as nearsightedness, farsightedness and astigmatism, and moderate to large differences in the vision of the two eyes. Like strabismus, amblyopia often runs in families.

How is strabismus and amblyopia diagnosed?

Vision examination by experienced optometrists leads to the diagnosis of strabismus and amblyopia. Whether a parent observes their child's eye turn or simply brings the child to us for a routine vision examination, we perform tests of the visual system selected to test eye teaming, focusing, depth perception, eye movements, eye-hand-body coordination and eye health. The results of our optometric tests will provide an understanding of the child's visual function, and if strabismus or amblyopia is diagnosed, the doctor will recommend appropriate steps to treat it.

We highly recommend first vision examinations by age 3, or as soon as a problem is detected.

What is the treatment for strabismus and amblyopia?

Strabismus and amblyopia can be treated depending on the severity of the problem. The eyes need to be retrained to gain greater coordination and control, and the visual system re-learns how to integrate and work with body movements and balance.

When diagnosed, the retraining process (vision training, vision therapy) can begin at any age, even infancy, by using systematic visual activities under the supervision of Dr. Cohen and his staff. Our treatment for strabismus and amblyopia incorporates vision training with lenses and prisms. Because of the complexity of the treatment program, considerable time and participation is required of the doctor, staff and the patien's family. Beginning treatment as soon as possible offers the best outcome for strabismus and amblyopia.