Strabismus:-

Strabismus is when eyes don't line up or when one or both eyes wander. The
eyes may turn:
 inward (called esotropia or "cross-eyed")
 outward (exotropia)
 up (hypertropia)
 down (hypotropia)
Strabismus, a misalignment of the eyes, is one of the most common eye
problems in children, affecting approximately 4 percent of children under the age
of six years. Strabismus is also called "wandering eye" or "crossed-eyes."
Causes:-
 Unknown cause
 Genetic or environmental influences
 Due to other congenital anomalies like:-
Cerebral palsy, down syndrome, braintumor, hydrocephalus, prematurity
etc.
 Cataract or another eye injuries
 Family history
 Neuromuscular disorders
 Drugs and toxins

SIGN & Symptoms:-

 Not persist in newborn
 Symptoms may persist on 3-4month old infant when he/she
focus an object eye seems to be crossed
 Childrens may develop second vision loss amblyopia also
known as lazy eye.
  So e childrens complain double vision which affect the
reading skills and classroom learning

Diagnostic Evaluation:-
1. Inspection-
 Do the eyes appear straight?
 Is the face turn or head posturing?
 The presence of straight eyes with a face turn in a face turn
in a patient who has strabismus can indicate the presence
of binocular fusion.
2. Amblyopia assessment/visual acuity
3. Sensory test
4. Duction and version
5. Light reflex test

Treatment:-
The earlier strabismus is treated, the better. This is because key
connections between a child's eyes and brain form by about 8 years old.
Treatment for strabismus may include:

 eyeglasses
 eye patching
 eye drops
 eye muscle surgery
Sometimes, wearing eyeglasses is enough to straighten out the eyes. If not, a
child might be given an eye patch to wear over the straight eye for a few hours a
day. This patch makes the weaker eye do the "seeing" work. Over time, the
muscles and vision in the weaker eye become stronger.
Getting a baby or toddler to accept wearing an eye patch can be a challenge.
But most kids get used to the patch. Wearing it becomes part of their daily
routine, like getting dressed in the morning.

Sometimes, though, kids refuse to wear an eye patch. Then, eye drops
(called atropine drops) might be used instead. Just as eye patching blocks the
vision in the straight eye, the atropine drops temporarily blur out vision in that
eye. This makes the weaker eye work harder so that eye muscles and vision get
stronger.
If eyeglasses, eye patching, and/or atropine drops can't fix a child's
strabismus, eye muscle surgery might be needed. Surgery involves loosening or
tightening the muscles that cause the eye to wander. Most kids can go home the
same day of surgery.