Adult Strabismus

See also: Strabismus and Pediatric Ophthalmology & Strabismus

Phoebe Lenhart, MD
Jason H. Peragallo, MD
Natalie C. Weil, MD

Emory Eye Center's subspecialty, Adult Strabismus, focuses on treatment of strabismus in adults and on adult strabismus research.

Strabismus is an eye disorder in which both eyes are not properly aligned and point in different directions either consistently or intermittently. There are many types of strabismus based on the direction of the misaligned eye(s):

  • Esotropia (inward)
  • Exotropia (outward)
  • Hypertropia (upward)
  • Hypotropia (downward)

In addition, if the misalignment occurs in the same eye it is called unilateral strabismus; alternating strabismus is when each eye switches in misalignment.

Strabismus is common among children, especially those with disorders that may affect the brain, but can also occur later in life. Children with strabismus may have double vision due to the misalignment of the eyes, but double vision is more common in adults with strabismus. In order to compensate for this, the child’s brain may begin to ignore the images from one of the eyes. If the images from one eye are constantly ignored without treatment, this may cause strabismic amblyopia, a condition in which there is reduced vision in the eye.

Signs and symptoms

The main sign of strabismus is the visible misalignment of the eyes. Parents often notice the misalignment when the child is daydreaming, ill, tired, or squints one eye in bright sunlight.


There are six muscles that control the movement of each eye. The muscles in each eye must be coordinated and work together to produce normal, balanced, binocular vision. When both eyes are coordinated, the brain combines images from both eyes to create a single, 3D image. When the eyes are misaligned, children may see both images and may also lose depth perception.

Adults are more likely to have double vision as they have already learned to receive images from both eyes and cannot ignore either image as children usually do.


Strabismus often can be treated with:

  • Eyeglasses or contacts
  • Patching/covering or blurring (with eyes drops) of the better-seeing eye to strengthen the weakened eye
  • Strabismus surgery to strengthen and realign the eye muscles



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