Crossed eyes in children


        CROSSED EYES IN CHILDREN

A crossed eye is a condition in which one or both eyes turn inward toward the nose. In many cases, it is caused by improper functioning of the eye muscles.
The eyeballs are turned in all directions by six tiny muscles that lie within the bony socket of the eye. These muscles keep the eyes parallel when the child looks at a distant object (more than 20 feet). These muscles turn the eyes slightly inward when they are focusing on closer objects.
Infants learn to focus their eyes during the first three to six months of life. The eyes may occasionally turn in (esotropia, internal strabismus) or out (exotropia, external strabismus) in relation to each other during this learning period. These conditions may briefly occur even up to age one and still be considered normal. When an infant's eyes are continuously not parallel, when they are not parallel more and more often at any age, or when they are not parallel past age one, the situation is abnormal and requires your doctor's advice.
Although most cases of crossed eyes are caused by improper muscle function, some are caused by a vision problem in one or both eyes. Anything that can cause crossed eyes can also cause the development of a "lazy eye" (amblyopia ex anopsia). If lazy eye is not corrected by age seven, disuse may cause a loss of sight in that eye.

Signs and symptoms
Watch the relationship of the eyes to each other as the child focuses near and far, looks to either side, and looks up and down. If the eyes seem to turn inward more than usual, consult your doctor.
Be aware, however, that many young children may appear to have crossed eyes, but the child's eyes are actually straight. Many infants and young children have an extra skin fold at the side of the eyelids by the nose. This fold of skin appears because of the tininess of the bridge of the nose. This extra fold allows more white of the eye to show toward the temples than toward the nose; this creates an illusion of crossed eyes.
Straightness of the eyes is best judged by observing the position of the highlights in both eyes; the highlights are the points where light is reflected in the eyes. If the highlights are in the same position in both eyes, the eyes are parallel.

Home care
There is no home treatment except under the supervision and instructions of your doctor.

Precautions
• If the pupils of your child's eyes are not equally black, smoothly round, and the same size, see your doctor.
• If your child's eyes are not parallel, see your doctor to avoid the development of a lazy eye.
• All children should have their vision checked annually, from age four or five on.

Medical treatment
Your doctor will check the eye muscles and vision and inspect the inside of the eyeballs. This examination can be done on any child at any age. If the doctor diagnoses crossed eyes, treatment will depend upon the cause. It may include eye surgery, glasses, patching of one eye, daily use of eye drops, or eye muscle exercises guided by a specialist. If crossed eyes are diagnosed or suspected, your doctor will probably recommend that you consult an ophthalmologist (a physician who specializes in eyes).

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GENERAL HEALTH

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