Children can be cruel when it comes to teasing classmates if there is something that isn't considered "normal" about them. When it comes to the eyes crossing, the visual cue that there is something different can set off embarrassment or shame. This medical condition can be treated to help improve the child's vision and help reduce the social stigma.
Definition
The American Association for Pediatric Ophthalmology and Strabismus states that the medical term for eye crossing is strabismus, which means any misalignment of the eyes. When the eyes cross inward it is called esotropia. When eyes cross in children, there is one eye that looks straight out while the other looks in towards the nose. Crossed eyes can be present at birth or develop as children age. There are three forms of esotropia: infantile esotropia, accommodative esotropia and sixth nerve palsy.
Causes
If a child has congenital or infantile eye crossing, the cause may not be known. In these cases, the child may rotate vision between the two eyes. If crossed eyes are due to accommodative esotropia, the cause is the eyes straining and needing farsighted glasses. Crossing of the eyes can be the result of the eye muscles failing to work together to coordinate movement. In some children, pseudoesotropia is present, which is where the eyes may look crossed but they are normally aligned. This condition can be seen in children with a broad, flat nose bridge, which makes the skin on the inner part of the eyelids cover the inner part of the eye.
Treatment
To treat crossed eyes in children, the main objectives are to realign the eyes properly and make sure that vision is maximized in each eye, not just one. Testing and fitting children for eyeglasses either with a prism or bifocals may be used as a frontline treatment. In some cases, surgery on the eye muscles is necessary. Surgery is done under a general anesthesia in an outpatient setting with the eye muscles repositioned to help straighten the eye.
Problems
Children with crossed eyes are more likely to develop a lazy eye condition as well. The medical term is amblyopia. In amblyopia, the vision in one eye is worse than the other and is due to lack of use in that eye during childhood. Crossed eyes that do not receive treatment can also lead to visual cues not being read or learned properly. With esotropia, the brain doesn't interpret signals from the affected eye and it does not develop normal vision pathways.
Considerations
Crossed eyes in children are common and the risk is higher if there is a family history of the condition. The drifting of one eye towards the nose can be constant or come and go, sometimes making diagnosis difficult. It is a myth that children will simply outgrow crossing eyes. To correct the problem, treatment options must be undertaken. If the condition is not diagnosed and treated early, vision can be permanently affected.
