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Dr. Alan Greene on Convergent Strabismus


I think my 3-year-old son has a mild case of convergent strabism. How can this be treated?


Strabismus is quite common in kids, affecting about one in 25 kids. Convergent strabismus or esotropia is a condition where the eyes turn slightly in. Often convergent strabismus is caused by farsightedness. When it is, glasses to correct the farsightedness are usually the best treatment for the short run. These kids usually love their glasses, both because they can see better, but even more because eye muscles can relax. They will usually not need the glasses once they have outgrown their farsightedness.

If farsightedness is not the cause, then patching is usually the best treatment. If patching is not successful, then surgery on the eye muscles is sometimes done.

Amblyopia, or lazy eye, is often the result of strabismus -- one eye stops seeing as well as the other. For amblyopia, eye drops can take the place of patching. There was a great study published in March 2002, where half the kids wore patches for six hours a day for six months and half had one eye drop per day. The two groups improved about the same.

There is another situation called pseudostrabismus where it looks like the eyes turn in but they are really straight. It's just that the bridge of the nose is wide and this situation gets better on its own as kids grow into their faces. When there is a question, kids should get tested by a pediatric ophthalmologist. If there is real strabismus, even if mild, the results are much better if treated early.

