This article has been provided by Dr. Huseyin ACAR to give information about ‘Cross Eye (Strabismus) in Children and Its Treatment’ in general terms.


As we all know, we see the object as single although we have two eyes. The reason for this phenomenon is that signals obtained by our two eyes are then transmitted to the visual cortex of our brain converting these signals into one visual piece. In order to obtain the single image, the perceived images should be the same. If the perceived images are not the same, our brain cannot combine them. As for the images to be the same, it is only possible when both of our eyes focus on the same point. Focusing on the same point by our eyes is provided by six muscles around our eyes controlled by our brain. Cortexes in our brain enable our eyes to focus on the same point by stimulating these muscles with the help of various nerves.


Image 1: Focusing on the same point by our eyes is provided by six muscles around our eyes controlled by our brain


Cross eye or strabismus means that our eyes focus on different points rather than concentrating at one point. The main problem is mostly that the brain cannot control eye muscles at a sufficient manner. Problem may lie in the cortexes of the brain, eye muscles or the nerves enabling the brain to control the eye muscles. The eyes may cross into the direction of down or up side and left or right side as per the impacted area. According to the level of impact, strabismus patients can be divided into two categories: those with permanent cross eye and those who have cross eye disorder from time to time.

Image 2: The eyes may cross into the direction of down or up side and left or right side as per the impacted area



Dividing child age strabismus into two categories as the permanent ones and episodic ones would make it easier to understand the subject matter. In permanent cross eye disorder, the control power of our brain over the eye muscles have been completely lost due to some various reasons. As for the episodic cases, ability of our brain to control is on the edges and in some periods it losses the control. Cross eye in such patients occurs when they are tired, or got ill or have a faraway look or are in sleepy mood.


In terms of treating the childhood cross eye, we come up with three main groups. The first group is the cross eye that can be cured by usage of eye glasses. The second group is the one that can be cured by a surgery intervention rather than usage of eyeglasses. And the third and the last group is that cross eye can be cured partially by usage of eyeglasses but any way it requires a surgery intervention for a complete recovery.  What is initially required to do for the child having cross eye is to determine into which category the patient falls and then accordingly to decide the treatment strategy.

Cross eye in the patients of the first group with whom the cross eye can be cured by use of glasses appears usually around interval of 1 and 1,5 years, and gradually it may increase. The eye glasses should always be worn since cross eye bounces back again during the periods where the patients do not wear the eye glasses. Additionally lazy eye (or amblyopia) of the patients in this group, if any, should also be cured in an effective manner.

Image 3: One type of childhood strabismus that can be treated with eyeglasses

In the second group, namely the group in which cross eye can be recovered by a surgery intervention, the common reason of cross eye is the insufficient control of the brain over the eye muscles. Strabismus in this group generally occurs at the first year of the life. There is no distinctive number for the eyes of the patients and consequently use of eye glasses generally does not yield any benefit.


A medium level of eye glass number is found at the examination of the patients in the third and the last group category. Cross eye is not completely recovered although use of eyeglasses decreases the cross eye level. Before taking decision of a surgery intervention for those patients, they should be followed up for a while and after making sure that cross eye cannot be cured by use of eyeglasses, it would then be more correct to proceed to the surgery. Surgery should not interfere to the part that can be recovered by eyeglasses use. Thus the patient is required to continue wearing eyeglasses after the surgery operation. In case that eyeglasses are not used, the part of the cross eye subject to the wearing eye glasses would remain in force. Lazy eye (or amblyopia) of the patients in this group should also be treated in an effective manner as in the other two groups.



Childhood cross eye or strabismus may prevail not only during the birth giving but also may appear in the later years. Such kind of cross eye within this period can basically be categorized into the three groups. These are; the group subject to number of eyeglasses, the another group related to the disorder caused by the loss of the brain control over eye muscles, and the last group related with mixture of both of the previous groups. The question to which sub type group belongs to the patient’s disorder determines either the treatment should be done with surgery or with use of eye glasses. Another issue at the childhood strabismus is lazy eye (or amblyopia). Also this case is as an important matter as strabismus itself since lazy eye disorder can only be treated up to the certain age of childhood.