Strabismology is the field dealing with the treatment of problems related to misalignment of the visual axes. Strabismus affects approximately 5% of the population.

Depending on the method of classification, the following types may be identified:

  • esotropic (cross-eye) strabismus, in which one eye (or, more rarely, both) points inwards
  • exotropic (lazy- or wall-eye) strabismus, in which one eye (or, more rarely, both) points outwards
  • hypertropic (vertical misalignment) strabismus, in which the eyes are at different heights


  • early-onset strabismus, which is present at birth or arises during the child’s first years
  • acquired strabismus,


  • constant strabismus
  • intermittent strabismus.

Some forms of strabismus are linked to paralysis of one of the muscles that move the eye, and may be present from birth (congenital) or acquired.

Other forms of strabismus may be linked to diseases such as hyperthyroidism or myasthenia (muscle weakness), or may be the result of accidents (such as fracture of the orbital floor, etc.)
We have six muscles in each eye that allow us to move the eye in three directions: horizontal, vertical and torsional (when we tilt our head). These six muscles are controlled by three cranial nerves.

The importance of detecting strabismus

In children, the misalignment of one eye may lead to amblyopia. Amblyopia is the term used to describe when eyesight does not develop normally. It is due to the fact that, if both eyes do not focus on the same image, the child’s brain is able to suppress the image coming from the misaligned eye in order to avoid confused images or double vision. This ability is lost after about 7 years of age, and as a result double vision occurs if the strabismus appears later in life. It is crucial to detect the presence of amblyopia as early as possible in order to begin the necessary treatment to ensure the best possible visual capacity. Indeed, the amblyopia will unfortunately become irreversible if left untreated after the age of 7.

Disturbing visual behaviour

  • Blinking, headaches after school or at the end of the day, children rubbing their eyes, sensitivity to light, redness of the eye
  • In case of strabismus
  • In case of abnormalities: white pupil, opalescent cornea, white spot on the cornea, jerky eye movements (nystagmus), tearing…

Treatment of strabismus

  • Prescription of glasses or corrective lenses when necessary, with full optical correction in the case of esotropic strabismus, also known as accommodative esotropia.
  • Amblyopia rehabilitation: occlusion by patching the healthy focusing eye in order to force the weaker eye to be used. Methods other than patching exist and may be offered, depending on the situation.
  • The orthoptist plays a very important role in rehabilitation and care.
  • Surgery.


The aim of surgery is to realign the eyes by strengthening or weakening one or more of the muscles that move the eyes. This procedure cannot be carried out using laser.
Even when normal binocular vision (the ability to make the eyes work together and to perceive in three dimensions) is lacking, the operation improves binocular fusion which in turn improves interocular performance.
This operation is usually carried out in children at the age of about 4. However even when the operation is performed early, it does not restore normal binocular vision if this did not exist beforehand, nor will it treat the amblyopia. If performed on adults, the operation will also not restore visual capacity if the eye is amblyopic.
In most cases, strabismus surgery is carried out under general anaesthetic for both children and adults.
It can be performed at any stage of life.

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