eye, crossed

This is also known as "strabismus." It is normal for the eyes of newborns to sometimes drift out of alignment, especially when the child is tired or is trying to focus on something quite near. However, the rule of thumb I learned in residency was that after three months of age, any eye that crossed should be evaluated by an ophthalmologist. Crossing of the eyes could be an early warning of lazy eye (amblyopia), which if not detected can lead to permanent visual loss. Very rarely, it is a sign of a cancerous tumor growing in the eye (retinoblastoma). Talk to your doctor about this right away.

Many times the crossing of the eyes is more apparent than real. This is called pseudostrabismus. It is caused by the fact that babies have a little fold of tissue (the epicanthal fold) that covers the upper inner corner of the eye. Since humans are asymmetrical creatures, one eye is usually covered a bit more than the other for starters, and when the child glances a certain way to the side, it appears that one eye is crossing inward. Your doctor can show you how to check for symmetry of the little highlight on the pupils. Basically, if the highlight is in the same part of the pupil of each eye, the eyes are normally aligned. If the highlight appears to be in a different area of the pupil from side to side, tell your doctor.

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