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Strabismus and Tropia are medical terms for a vision condition that is called by various different names. Other names include cross eyed, crossed eye, cockeye, weak eye, wall eyed, wandering eyes, deviating eye, squint, hererotropia and others. Strabismus is a vision condition where one’s eyes are not able to properly align under normal conditions. One eye is misaligned in relation to the other when focusing on an object. Both eyes are not able to focus in the same direction, at the same point, at the same time. When a person’s eyes appear to be turned in (toward the nose), they are commonly called cross-eyed. This is more formally termed Esotropic Strabismus. When the eyes appear to be turned outward (away from the nose), the person is commonly called wall eyed. This is known as Exotropic Strabismus. When one eye appears to turn upward or downward relative to the other eye, this is called Hypertropic Strabismus. In some cases, the eye may turn in more than one direction.

Strabismus is the result of a lack of coordination between the extraocular muscles of the eye that is responsible for eye movement. Either one or both eyes may turn in, out, up or down when looking at an object. Strabismus prevents proper binocular vision and prevents both eyes from gazing the same point. Either peripheral vision or side vision may be affected. A patient’s perception of depth is distorted. Perception of depth is the ability to recognize the order of objects in three dimensions. Patients will also experience a limited field of view. Strabismus is not to be confused with amblyopia, which is also known as lazy eye. Lazy eye is the loss of vision in a strabismic eye.

Infants, children and adults are susceptible to some degree of Strabismus. Adults are more likely to develop Strabismus as a result of injury or disease and experience an exotropic condition. It is not clear why children and infants develop the Strabismus, but children will never outgrow the condition. Studies indicate that more than half of the children that develop Strabismus develop the condition during infancy, at or some time shortly after birth. Initially, children will suffer from double vision. Double vision is caused by the misalignment of one eye in relation to the other. To compensate for the misalignment, a child’s brain will eventually suppress any image received from the strabismic eye. As a result, the visual cortex of the brain will fail to completely develop and the strabismic eye will never develop to see well. This type of suppression or loss of vision is known as amblyopia (or lazy eye).

Amblyopia may be caused by only a minimal misalignment of the eyes. When the misalignment is minimal, the condition is called microtropia. Microtropia is difficult to recognize in small children since small children are not likely to cooperate in eye testing. Even with the most skilled ophthalmologist, microtropia is difficult to detect. An expert evaluation of the child’s visual activities is necessitated to diagnose the condition. If untreated, microtropia will develop into amblyopia.

Strabismus is rarely cured, but it may be effectively treated. Treatment may be as simple as requiring the patient to wear eyeglasses, to use prism lenses, to take medication or it may be best to leave the condition untreated. However, in most instances, the only effective treatment for Strabismus is surgery. Surgery will attempt to eliminate diplopia (double vision), expand the patient’s field of view, eliminate abnormal head posturing, improve depth perception and improve the patient’s psychosocial functions. Strabismus surgery is considered a corrective surgery that may also provide some cosmetic benefit to the patient.

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