Seeing something unusual in your baby’s eyes can be very unsettling. Parents often come to us concerned about a condition called strabismus, where the eyes are not properly aligned.
They may worry their child has “crossed eyes” or “wandering eyes.” We want to reassure you that while strabismus can be concerning, it is also highly treatable, especially in infants.
In today’s post, we will cover everything you need to know about the symptoms, causes, and treatment of infant strabismus.
Our goal is to provide you with the information you need to feel confident, reassured, and ready to take the next steps for your child’s eye health.
However, this is not a medical advice and shouldn’t be taken as one.
What Is Infant Strabismus?
Simply put, strabismus is a misalignment of the eyes. When a baby or child has strabismus, their eyes do not point in the same direction.
Instead of working together to focus on a target, one eye may be looking straight ahead while the other turns in, out, up, or down.
This misalignment can occur all the time or just when the child is tired, concentrating on a nearby object, or gazing into the distance.
Infant strabismus can become apparent within the first few months after birth. While it can be temporary in some cases, treatment is usually necessary to prevent long-term vision problems, such as amblyopia or lazy eye.
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Common Symptoms of Infant Strabismus
Often, it is the parents or caregivers who are the first to notice something unusual about a child’s eyes. Here are some of the most common signs of strabismus:
Eyes do not move together: Parents often notice one eye appears to drift inward, outward, upward, or downward, compared to the other eye. This misalignment may be constant or only occur intermittently.
Crossed eyes: Parents may notice their baby’s eyes appear to cross toward the nose, particularly when the baby is focusing on a toy or their caregiver’s face.
One eye “wanders”: In some cases, one eye may look straight ahead while the other seems to “wander” or point in another direction.
Closing one eye: Babies with strabismus may also compensate by closing one eye when trying to focus on something, particularly if they are in a brightly lit area.
Head tilting: Frequent head tilting or turning may be another symptom. Babies with strabismus may tilt or turn their heads to get better focus and avoid double vision.
Uncoordinated eye movements: Healthy newborns may experience some wandering of the eyes in the first few months as their vision develops. However, if drifting persists or becomes more pronounced after 4–6 months, it could be a cause for concern.
Related; 7 Things to Do When Your Baby Is Teething
When Should Parents Worry?
A bit of crossing and wandering in the first few months of a baby’s life is usually not a cause for concern.
The visual system is still developing, and some misalignment can be expected. However, if the misalignment persists or seems to be worsening, that could indicate a problem.
To help you know when to worry and when to wait, here is the timeline parents should follow:
Before 3 months old: Some eye wandering or crossing is likely harmless.
By 4–6 months old: The eyes should begin to work together consistently. Misalignment beyond 4–6 months may be a sign of strabismus.
If your baby’s eyes seem misaligned after six months of age, or if they are constantly misaligned at any age, you should make an appointment to see a pediatric eye doctor.
Related: What Are White Curds in Babies? Causes, Symptoms, and What to Do
What Causes Strabismus in Infants?
There is not always a single cause of strabismus; several factors can contribute to the condition. Some of the most common causes of infantile strabismus include:
Genetics: Strabismus is hereditary in many cases. If you or your partner had strabismus as a child, your baby is more likely to have it.
Refractive errors: Babies with significant farsightedness may cross their eyes as they try to focus.
Muscle imbalance: Weak or abnormally controlled eye muscles that move the eyes can cause misalignment.
Neurological conditions: Although rare, strabismus can sometimes be associated with other neurological conditions or problems in the brain and nerves that control the eye muscles.
Prematurity or low birth weight: Premature babies or those with low birth weight are at increased risk.
Related: Teething Tablets: Are They Safe for Babies?
Why Early Detection Matters
Strabismus that is left untreated can lead to a condition called amblyopia. This is when the brain ignores the signals from the misaligned eye, leading to a permanent loss of vision in that eye.
The earlier strabismus is detected, the sooner it can be treated. With early treatment, most children with strabismus can achieve good eye alignment and healthy vision.
Remedies and Treatments for Infant Strabismus
Pediatric ophthalmologists (eye doctors) typically recommend one or a combination of the following remedies to treat infant strabismus, depending on its cause and severity:
Glasses: If strabismus is related to farsightedness, glasses can help correct the refractive error and bring the eyes into alignment. Babies and toddlers can wear lightweight, flexible frames.
Patching: Patching involves covering the stronger eye with a patch for several hours a day. This forces the brain to rely more on the weaker eye, strengthening it and helping to correct the misalignment.
Eye Drops: Medicated eye drops can blur the vision in the stronger eye instead of patching. Drops usually contain atropine, which temporarily blurs vision.
Vision Therapy: Vision therapy is a series of exercises designed to train the eyes to work together. While more common in older children with strabismus, it may also be used to support other treatment options in toddlers.
Surgery: In some cases, surgery may be necessary to tighten or loosen the eye muscles. During surgery, the eye muscles are adjusted to improve alignment. This is a safe and effective procedure, with many children recovering quickly.
Regular Monitoring: Even after treatment, children should have regular eye exams to ensure their eyes stay healthy and aligned. Vision is rapidly developing in early years, so ongoing monitoring is essential.
What Parents Can Do at Home
While medical treatment is important, there are also things that parents can do at home to support their baby’s visual development:
Visual play: Use brightly colored toys and objects to attract your baby’s attention. Move toys from side to side to encourage the baby’s eyes to track together.
Alternate feeding sides: Switch sides when feeding your baby to ensure they use both eyes equally.
Limit screen time: Infants should not be exposed to screens (TV, computers, tablets, etc.) before 18 months, as screens may inhibit healthy vision development.
Follow doctor’s advice: If your pediatric ophthalmologist recommends glasses, patching, or other treatments, be sure to follow their directions and stick to the schedule.
Myths and Misconceptions About Infant Strabismus
“They’ll outgrow it.”: While minor wandering may improve in the first few months, true strabismus is not something babies outgrow. Early intervention is essential for treatment.
“It’s just cosmetic.”: Strabismus can lead to permanent vision loss, so it’s more than just a cosmetic issue.
“Surgery is the only option.”: Many children respond to glasses, patching, or other non-surgical treatment options. Surgery is only recommended in certain cases when other treatments are not effective.
Long-Term Outlook for Children with Strabismus
With early diagnosis and treatment, most children with strabismus will go on to have excellent vision and eye coordination. Many children with strabismus will never remember the treatments they received as infants, but they will be able to enjoy the benefits of clear, healthy vision throughout their lives.
Key Takeaways for Parents
Eye wandering is often normal in the first 3 months.
Misalignment beyond 4–6 months may signal strabismus.
Treatment prevents long-term vision loss.
Remedies can include glasses, patching, and even surgery.
Ongoing monitoring of vision is important.
Final Thoughts
As parents, we know you care deeply about your baby’s health and well-being, especially when it comes to their eyes.
If you notice your child’s eyes drifting, constantly crossing, or tilting their head to see better, we want you to know that you’re not alone. Strabismus is a common and treatable condition.
The most important thing you can do is be observant and proactive. If you notice symptoms of strabismus in your baby, don’t wait and see if they get better on their own. Schedule an appointment with a pediatric eye specialist right away.
The good news is that with early diagnosis and treatment, your little one has an excellent chance of seeing the world clearly and beautifully for years to come.
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