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Strabismus (crossed eyes, squint) is an eye problem where both eyes do not look in the same direction at the same time. Your child’s health care team might say the eyes are “out of alignment” or “misaligned.” One or both eyes may turn out, in, up, or down.
Your child may have a problem with:
Rarely, strabismus may be caused by a genetic disorder or other medical condition. These include:
The doctor may order one or more of these treatments to help your child:
If these treatments do not work, your child might need surgery on their eye muscles. They might need surgery on both eyes, even if only 1 eye looks in the “wrong” direction. Strabismus surgery helps to align the eyes so that they work together.
Before the procedure, medical staff will explain what to expect and answer any questions. Always follow the instructions given by your care team.
Strabismus surgery takes 2 hours or less. Your child will get general anesthesia. Most patients do not need to stay in the hospital overnight.
During the surgery, the surgeon will use a device to hold the eye open. They will make a small opening through the eye’s surface. The surgeon will detach the eye muscle and reposition it so that the eye goes into the correct, aligned position. Stitches will hold the eye muscles in place in the new position. The stitches will not need to be removed. They will dissolve on their own. The surgeon does not remove the eye during the surgery.
Your child’s doctor will give you antibiotic drops to put in your child’s eye after surgery. This medicine helps prevent infections. Be sure to follow the directions and use the right number of drops at the right time.
Your child’s eyes might look in the same direction and appear “aligned” right after surgery, or they might not. The eyes will look red and a bit swollen. They might get straighter within 1 or 2 days after surgery, but you might not be able to see it yet. Bruising and swelling may make it hard to tell how straight they are. Your child’s eyes might look straighter as they heal. It takes 4–6 weeks to know if the surgery was effective.
A cold pack can help control pain, reduce swelling, and keep your child more comfortable. You can use one of the following:
Wrap the ice pack or bag of frozen peas in a clean washcloth before putting it on your child’s eye. Do not leave the ice pack on for more than 10 minutes. It can be applied again in 1 hour. Follow the directions of your care team.
Strabismus surgery is generally safe, but there are risks with any surgery. Risks or possible complications include:
In some cases, surgery is not effective, and a second surgery may be needed.
Usually, your child can return to normal activities in 1–5 days.
Your care team will give instructions for home care after surgery. For 2 weeks after surgery, your child should avoid:
Although it is different for every child, most children can go back to school in 2–3 days, as long as they are recovering well and do not have double vision.
Avoid activities such as recess, gym, or PE class for 2 weeks after surgery.
Your child’s doctor might also ask your child to limit school or other activities so that they can heal. Always follow the instructions of your child’s care team.
Infection after strabismus surgery is rare. Even with the use of antibiotic eyedrops, an infection could happen.
Call your doctor or clinic if:
Reviewed: May 2023