One of the more common eye disorders in children is Strabismus, or crossed eyes. This is when both eyes do not look in exactly the same direction at the same time; in other words, a misalignment of the eyes. Strabismus may cause double vision, poor vision, and limited depth perception. With more than 3 million cases in the U.S. per year, it is estimated that 4% of the population has strabismus; a large number of that population being children under the age of 2.

DSC_0127Strabismus is the general term for misalignment of the eyes in ophthalmology, and there are several types of strabismus, or misalignment. These types are defined by the way the eye is misaligned. The most common types are:

  • Esotropia – inward turning
  • Exotropia – outward turning
  • Hypotropia – one eye is higher than the other
  • Hypertropia – one eye is lower than the other

In children, if strabismus is not treated, the misaligned eye is at risk for amblyopia. Amblyopia is the medical term for vision loss. This occurs because the eyes are oriented in 2 different directions and so the brain receives 2 different visual images. The brain may ignore the image from the misaligned eye to avoid double vision, resulting in poor vision development of that eye.

David Silbert, MD, FAAP and his team specialize in the diagnosis and treatment of Strabismus in children and utilize the best and most up-to-date methods. When necessary, Dr. Silbert also performs Strabismus surgery to correct the misalignment, which is an out-patient procedure done under anesthesia. This surgery often focuses on adjustments to the muscle around the eye and not the eye itself. In some cases strabismus can even be treated with just glasses. When a child is very farsighted they have to focus so hard theirs eyes may start to cross, by putting them in their correct glasses some children can avoid surgery and may eventually outgrown their glasses or be able to switch to contact lenses.


One of the most interesting ways to treat Strabismus is with the use of prisms. Each eye sees images. Then the eyes are aligned, they combine and make the “single view” of the world we see. When you see two images instead of one, that can mean your eyes are misaligned. When used in glasses, a prism actually moves the position of the image in your misaligned eye, removing double vision. At Conestoga Eye, we usually begin treatment with a temporary prism on a patient’s glasses (fresnel), as some patients may have an improvement or worsening in their symptoms the first few months. If the prism is needed long-term, Dr. Silbert can either perform surgery to permanently fix the eyes, or the prism can be incorporated into prescription glasses.


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