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Congenital Strabismus

more about Congenital Strabismus


Disconjugate gaze or "cross-eyed"



  • Congenital strabismus occurs when a child's eyes do not point in the same direction at birth.  A small amount of disconjugate gaze is normal in a young infant, because when babies are born, their brains are still growing, and they do not "learn" to control their eyes for several months.  However, even if disconjugate gaze does not resolve spontaneously, it can be easily treated in most infants.  If disconjugate gaze starts later in life, or occurs with other abnormalities such as muscle weakness, it can be a sign of more serious problems.

  • There are two main types of disconjugate gaze:
    1. Esotropia: The affected eye is turned inwards, towards the nose, while the other points straight ahead, i.e., "cross-eyed."
    2. Exotropia: The affected eye is turned outwards, away from the nose, when the other points straight ahead.
  • Older children with disconjugate gaze may complain of blurry vision or of "seeing double."

  • Children born with disconjugate gaze will usually require an examination by an eye specialist, or ophthalmologist, if the problem does not resolve by four months age.
  • Older children who develop this disorder after infancy may also need specialized studies to determine why their eyes are not functioning correctly.

  • For the majority of newborns, no therapy is needed, and the problem resolves spontaneously.
  • In older infants, several therapies may be necessary, depending upon the findings of the eye specialist:
    1. The unaffected eye may be covered with a patch, in an effort to "force" the brain to use the affected eye correctly.
    2. Glasses may be used to help the affected eye focus, if that is found to be the reason for the alignment problem.
    3. Surgery may be necessary to shorten some eye muscles to bring the eyes into alignment with each other.

  • If treatment is started early enough, most children have no vision problems and find that both eyes function normally.  However, if therapy is delayed, there is a risk that the brain will learn to "ignore" the affected eye.  This risk increases over time.




more about Congenital Strabismus


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