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With Strabismus, the eyes are not aligned. One eye may gaze straight ahead while the other eye turns inward, upward, downward, or outward. Strabismus is quite common and occurs in about 4% of children.

Esotropia (Crossed Eyes)

When an eye turns inward, the child has “crossed” eyes (Esotropia). There are two common causes for Esotropia:

  • Some children are born with crossed eyes (or develop it shortly after birth), and in this situation the muscles are too tight. Treatment for this most commonly involves surgery on the eye muscles, generally performed before the age of 2.
  • The second most common cause for Esotropia is excessive farsightedness. This problem can be present at birth, but most commonly occurs between the age of 2 and 6. This type of Esotropia is corrected with glasses.


When an eye turns outward, the child has Exotropia.

  • Exotropia may be present from birth, but most commonly is seen in children ages 2 to 7.
  • Generally the eyes turn out on rare occasions at first but with time more frequent outward turning of the eyes is noted.
  • Children with Exotropia occasionally squint one eye when exposed to bright sunlight. The treatment for large amounts of Exotropia is usually eye muscle surgery.

Children with misaligned eyes will generally turn off the vision in the turned eye so that they are not plagued with double vision. Children with Strabismus should have a careful examination by a Pediatric Ophthalmologist because untreated Strabismus may lead to a lazy eye (Amblyopia) or loss of depth perception.

To learn more about strabismus surgery, or surgery to improve eye alignment, watch this video featuring North Carolina Eye, Ear, Nose & Throat Pediatric Ophthalmologist Dr. Sara Grace.

Pediatric Services Available

At NCEENT, we take care of each child as if they were our own. By offering a wide range of pediatric services, including pediatric pediatric vision care, our providers treat a vast number of common disorders.