Cross Eyed Baby (Strabismus)

160 days / 5 Months 1 Week and 3 days old baby

Dad is thinking a bit much about my cross-eyed eyes (Indonesian, mata juling). He wonders if it can correct itself or does he need to bring me to doctor / pediatrician or ophthalmologist to check this out? Is my cross-eyed eyes a Strabismus or pseudostrabismus" or "pseudosquint?

If you don't know what Strabismus is, here's the definition:

"Strabismus, or misalignment of the eyes, is a common condition encountered in children. In fact, it may effect up to four percent of all children younger than six years of age."

What's the effect?

This disorder can disable sight in one eye and have significant psychological effects as well. Thus, restoration of the proper alignment of the eyes at an early stage of visual development is crucial.

The eyes crossing is rather common and considered normal under two months of age. However, if the eyes continue to cross when the child is three and four months of age, then the conditions of exotropia (eyes moving outward) or esoptropia (eyes crossing inward) become more of a concern. I agree with your pediatrician. If there is concern that your child has true strabismus, esotropia, or exotropia, an evaluation by the ophthalmologist is necessary.

What can be done to fix strabismus?
Treatment can help your child to have normal vision. The earlier the treatment is started, the better. The goal of treatment is to make the weak or wandering eye do more work and get stronger. Sometimes this means the child has to wear corrective glasses. Or the child might wear a patch on the "good" eye or have drops put in it. This blocks the vision in the stronger eye, which forces the weaker eye to work harder. Your child may not like to have these treatments, because the weak eye doesn't see as well at first as the other eye. Even if your child doesn't want to wear glasses or an eye patch, this treatment is very important. It can help your child see better as a child and as an adult.

Some children need an operation to straighten their eyes. The operation is usually considered after the weak eye has gotten stronger by being used more with the treatments listed above. The surgery is fairly simple, but it doesn't always make the eyes exactly straight. Sometimes it has to be performed again later on.

How long does treatment last?
Since the most important part of treating strabismus is to force the weak eye to work harder, it's very important that you follow the directions the doctor gives you for eye patching or eye drops. Usually the treatment will go on for months or even a few years. Sometimes less patching (or fewer eye drops) will be needed as time goes by. This treatment usually helps make the weak eye as strong as the good eye.

When your child is about 7 or 8 years old, the vision in the weak eye will be as good as it can get with treatment. The earlier treatment starts, the easier it is to fix the problem. So watch for signs that your child doesn't see well, or for eyes that cross or wander apart. If you have any questions, always ask your family doctor.

Pseudostrabismus or pseudosquint

Pseudostrabismus is an optical illusion in which normal aligned eyes appear crossed due to an optical illusion. This appearance may be due to a wide, flat nasal bridge and/or prominent skin folds at the inner eyelids. These characteristics hide a portion of the white part of the eye creating the impression that one eye is turned toward the nose. This appearance resolves as the child gets older and causes no visual problems.

I hope, my cross-eyed is just this pseudostrabismus thing.

Dad plans to bring me to pediatrician, Bu Nuke of Melati Husada Malang, next Saturday to make sure of my cross-eyes problem.

If you are a doctor, please have a look at my eyes, do I suffer from strabismus or pseudostrabismus?