wandering eyes unable to see

Adult Strabismus

• • A condition in which eyes wander to one side, cross, or are higher or lower than the other
• • Symptoms include double vision, which can start suddenly or gradually
• • Treatment includes placing prisms or opaque films in eyeglasses; surgery is also an option
• • Involves ophthalmology
• Strabismus (crossed eyes)
• Strabismus Surgery
• Optic Nerve Hypoplasia
• Pediatric Ophthalmology
• Hemiballismus

What are the symptoms of adult strabismus?

What are the most common types of strabismus, what causes adult strabismus, how is strabismus diagnosed, what are the treatment options for adult strabismus, what makes yale medicine’s approach to treating adult strabismus unique.

People who see second lines of print while they're working at their computer or see a car heading down their lane while they're driving may be suffering from strabismus, says  Martha Howard, MD , a surgeon at the Yale Medicine Pediatric Ophthalmology & Strabismus Program . "It can be very frightening,” says Dr. Howard.

Strabismus is a condition in which the eyes are not aligned. It affects people’s ability to function and can even cause them to lose their independence. Fortunately, in many situations, it’s also very treatable. Yale Medicine offers an array of strabismus specialists who have a deep knowledge of conditions, treatment and procedures.

An adult with strabismus will experience double vision. The onset can be sudden or gradual, says Dr. Howard. The distortion may occur only sometimes or in specific circumstances.

Strabismus may be intermittent at first and then become constant. “It may only happen when you look in a particular direction,” says Dr. Howard. “For some people, it may occur only when they are looking to one side."

Many times, the appearance will be obvious to outside observers. “But sometimes only family members or friends will notice that the eyes are not aligned,” Dr. Howard says.

Children with strabismus don’t see the second image because their brains suppress it. Adult brains don’t have that ability.

An estimated 4 percent of adults in the United States will experience strabismus in their lifetimes. The condition can be further described by the direction of the misalignment.

• Esotropia, the eyes cross inward
• Exotropia, one or both of the eyes look outward
• Hypertropia, one eye moves up out of alignment
• Hypotropia, one eye moves down out of alignment

Some adults with strabismus were born with the condition. It may have first appeared when they were children, but corrected itself as they matured. The risk of adult strabismus increases with age, so the condition can reappear when a person gets older.

“Unfortunately, as we age, our eye muscles do not function as well as they did in the past,” says Dr. Howard. “We call that decompensation.”

Such other health problems as circulation or neurological problems can lead to strabismus. Mini-strokes, diabetes and hypertension can impair the circulation to the muscle or to the nerves that control them. “Damage to different cranial nerves can cause strabismus and double vision,” Dr. Howard says.

Strabismus can occur in people with a history of thyroid disease, even if the thyroid blood levels are in control. Tumors in the brain stem or in the eye can cause strabismus as can trauma.

Diagnosing strabismus starts with a simple test: covering and uncovering each eye.

“When either eye is covered, the double vision resolves,” says Dr. Howard. “That’s a distinguishing feature. If you cover an eye and the double vision remains, that’s not strabismus.”

The ophthalmologist will perform a complete exam and check a patient’s ocular motility, which describes how well the eyes move in various directions. The physician will also measure the misalignment with prisms. “From that information, we can identify what kind of strabismus the patient has,” she says.

“In some situations, the double vision will resolve with time,” says Dr. Howard.

In some patients, strabismus can be improved by placing prisms in their glasses. In other cases, one eye must be covered with an opaque film over one lens of a person's glasses to eliminate the second image.

Surgery can play a significant role in improving the symptoms of strabismus. When necessary, surgery is usually performed with local anesthesia in an outpatient setting. However, general anesthesia is possible as well.

“I often use adjustable sutures,” says Dr. Howard. This allows post-surgery fine-tuning with topical (eye drop) anesthetics.

We have the only program for strabismus in southern New England located within an academic medical center. We are experts in diagnosing and treating strabismus disorders in adults. Our ophthalmologists understand the available options to improve symptoms of strabismus, including surgery if prisms become unwieldy.

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• COVID-19 Vaccines
• Occupational Therapy
• Healthy Aging
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

Strabismus (Crossed Eyes) Overview

Strabismus is a group of conditions where one or both eyes are not aligned or pointed in the same direction. If one eye is not aimed at the same target as the other eye, two images will result, causing  double vision . Although strabismus usually shows up in infancy or early childhood, adults can develop strabismus as well.

Humans have six eye muscles per eye that allow for eye movement. These muscles constantly receive nerve signals from the brain that control eye movement and allow the eyes to coordinate movements together so that both eyes are pointed at the same target. If the information received from these nerve impulses is incorrect, the eye may turn in, out, up, or down.

Strabismus can affect one eye or both eyes. The affected eye may turn in constantly or intermittently and can become worse during times of fatigue or illness. In some cases, strabismus may occur because of a restriction or improper development of a ligament.

Using both eyes properly is important for good depth perception. If one eye is not being used, then depth perception is limited. If one eye is not pointed at the same target, double vision may result. In order to deal with seeing two images, the brain may suppress one of the images so that you will only see one image. The brain soon learns to ignore the second image.

Strabismus is named according to the direction in which the eye deviates.

• Esotropia occurs when an eye turns inward.
• Exotropia occurs when an eye turns outward.
• Hypertropia occurs when an eye turns upward.
• Hypotropia occurs when an eye turns downward.

Some types of strabismus are caused by abnormal development of the binocular system in the brain. The accommodative system (focusing system) allows our eyes to change power and focus so that objects remain clear no matter the distance. The binocular/alignment system controls how our eyes work together. When we look far away, our eyes are straight. When we look at something very close, our eyes converge or turn in and our eyes increase their focusing power. When we look back to a distance, we relax our focusing power and the eyes become straight again.

Young children have huge amounts of focusing power. As a result, when a child has a very large amount of uncorrected farsightedness , the child attempts to make things clear by focusing extremely hard. In order to achieve that, they must focus a great deal to compensate for the uncorrected vision problem. When they focus this much, the binocular and focusing systems begin to get mixed signals. Usually, one eye will turn in. This is called esotropia.

The focusing system will also begin to send signals for the eye muscles to converge the eyes inward. When the eyes are forced to focus this much, abnormal signals go to the eye muscles causing one eye to turn in and become crossed. Some children may not compensate and their eyes will not turn in, but they will have very poor vision because they are not over-focusing. Their brain chooses to keep the muscles straight, but they see a very blurred image.

Other types of strabismus, such as exotropia, also sometimes referred to as wall-eyed or a wandering eye may be caused by a large difference in the eye’s refractive status between the two eyes. When there is a difference in the refractive power between the eyes, or a difference in the ability to bring an object into focus, the weaker eye may not receive the same sensory input as the stronger eye. Over time, the brain may choose to ignore the eye with the weaker visual input (also known as amblyopia), and the eye drifts outward (exotropia).

This also occurs when a person has an eye disease that causes long-standing decreased vision. The brain does not receive good information from that eye and it may begin to wander outward. In many cases of childhood exotropia, there is no detectable cause.

Vertical deviations, where one eye may be up or one eye down, are often caused by a palsy in the fourth cranial nerve. A palsy is often caused by trauma, stroke to the muscle or nerve and more rarely, a tumor. Vertical strabismus can also be caused by neurologic problems, thyroid disease and fibrosis or scarring that is sometimes a part of eye muscle syndromes that people are born with, such as Duane’s retraction syndrome.

Temporary or False Strabismus

Parents often see intermittent eye crossing in their infant children, usually during the first six months. This is a sign of normal development and is simply a sign of children learning to use their eyes together. However, this intermittent cross is quite rare after six months of age and if it is seen after that time, parents should seek the advice of their pediatrician or a pediatric optometrist or ophthalmologist.

The term pseudo-strabismus is given to certain infants and young children that only appear to have crossed eyes. This is seen in certain ethnic groups where the bridge of the nose is flatter than average or extra skin covers the inner corner of the eyes. This extra skin is referred to as epicanthic folds. This sometimes gives the appearance of slightly crossed eyes and usually goes away as the child’s face grows.

Strabismus is treated in a variety of ways. Your eye doctor will be able to determine the best treatment plan for you.

When a child develops accommodative esotropia due to the eyes over-focusing to compensate for their large amount of uncorrected farsightedness,  the treatment is to correct the child’s vision problem fully . After an appropriate eyeglass prescription is worn, the eye will no longer over-focus, and the eyes often straighten out immediately. Correcting the vision problem often eliminates most of the deviation, but it may still occur when converging the eyes in during reading. In this case, a bifocal lens is prescribed to give added power.

Prism is a type of lens that bends light in a particular direction. Eye doctors  can prescribe a prism lens  to move objects over to a position that allows the wearer to fuse images, so double vision does not occur. This is crucial for some patients who experience double vision as a result of strabismus. In certain cases, the opposite power prism can be prescribed to enhance the cosmetic appearance of strabismus.

Vision Therapy

Vision therapy (VT) encompasses different techniques to either correct strabismus or allow the person suffering from strabismus to learn when an eye deviates so that they can learn to use their eye muscles to minimize it. Sometimes certain machines and computer software programs are used to give the person behavioral feedback to control the eye muscle deviation. Other times, specific eye muscle exercises are performed to strengthen the eye muscles. VT is very successful in exotropia and minor esotropia deviations but not as successful in large amounts of esotropia.

Vision therapy is considered controversial. Some ophthalmologists do not recommend vision therapy except in the case of convergence insufficiency (a disorder most common in infants and children in which the eyes have difficulty working together when focusing on a nearby object), and some insurances do not cover vision therapy, as well. Talk to your healthcare provider about whether vision therapy is right for you or your loved one, and discuss your coverage options with your insurance provider.

Botulinum toxin is injected directly into one of the muscles controlling eye movement. This temporarily blocks the nerve impulse and causes the muscle to be paralyzed. This muscle relaxes and the other eye muscles take up the slack to straighten the eye. Injections for strabismus was one of the first uses of Botox in health care.

Eye muscle surgery for strabismus is very successful in most cases. Eye surgeons who specialize in eye muscle surgery use a variety of techniques that involve shortening or moving eye muscles. Adjustable sutures are used to fine-tune the eye muscle correction directly after surgery.

Gunton KB, Wasserman BN, DeBenedictis C. Strabismus. Prim Care .2015;42(3):393-407. doi:10.1016/j.pop.2015.05.006

Bui Quoc E, Milleret C. Origins of strabismus and loss of binocular vision.   Front Integr Neurosci . 2014;8:71. doi:10.3389/fnint.2014.00071

Audren F. Les strabismes divergents intermittents .  J Fr Ophtalmol . 2019;42(9):1007-1019. doi:10.1016/j.jfo.2018.12.031

Sharma P, Gaur N, Phuljhele S, Saxena R. What’s new for us in strabismus?  Indian J Ophthalmol . 2017;65(3):184-190. doi:10.4103/ijo.IJO_867_16

Rowe FJ, Noonan CP. Botulinum toxin for the treatment of strabismus. Cochrane Database Syst Rev . 2017;2017(3):CD006499. doi:10.1002/14651858.CD006499.pub4

Boyd, Kierstan. What Is Strabismus? American Academy of Ophthalmology (AAO).

By Troy Bedinghaus, OD Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.

Jump to content

Updated visitor policies

Other michigan medicine sites.

• Michigan Medicine Gateway
• UofMHealth.org
• Medical School
• Clinical Research
• For Health Providers
• Patient Portal Login

Kellogg Eye Center | Michigan Medicine

Federated search page form block, quick links.

• For Medical Professionals
• Maps, Directions, Parking

Strabismus (Misaligned Eyes, Crossed Eyes, or Wall Eyes)

What is strabismus.

Strabismus is a visual disorder in which the eyes are misaligned and point in different directions. This misalignment may be constant or intermittent.  When the eyes are misaligned, typically one eye will fixate on objects of interest while the other eye turns in (esotropia), out (exotropia), down (hypotropia), or up (hypertropia).

Often times the eye that is fixing on objects switches; that is, the misaligned eye will fixate and the previously fixing eye will become the misaligned eye.  This alternation of deviating eye is often a good sign suggesting that the vision in each eye is equal.  On the other hand, if the eyes do not switch fixation (one eye is constantly the fixating eye and the other eye is constantly the misaligned eye), then the fixating eye is favored and almost always has better vision.

Esotropia and exotropia are common conditions among children. Eye misalignment typically results in double vision in adults, but the developing brain in a child deals with the double vision by suppressing one of the images.  Therefore, abnormal eye alignment in childhood blocks normal binocular vision development (as the brain learns to rely on only one image from the fixing eye).

Although the avoidance of double vision is beneficial in some regard, this adaptation by the developing brain is also detrimental because the ignored eye loses the ability to see perfect “20/20” vision – a condition called amblyopia.  Amblyopia is decreased vision in a perfectly healthy and well-formed eye which occurs because of a loss of the connection between an eye and the brain during a critical period of vision development from birth to 8 or 9 years of age.  Young patients with eye misalignment also typically have poor stereo or 3D vision and depth perception.

Strabismus in adults often results in double vision because the brain has been trained to receive images from both eyes.  Adults with strabismus are not at risk of developing amblyopia because the connections between the eye and the brain are already formed and cannot be suppressed.

• Misaligned eyes
• Possibly also decreased vision

The symptoms described above may not necessarily mean that your child has strabismus; however, if you observe one or more of these symptoms, contact your child's eye doctor for a complete exam.

The causes of eye misalignment are various, and sometimes unknown.  Potential causes include high farsightedness, thyroid eye disease, cataract, eye injuries, myasthenia gravis, cranial nerve palsies, and in some patients it may be caused by brain or birth problems.  Six eye muscles control eye movement and are attached to the outside of each eye. Two muscles in each eye move the eye right or left while the other four muscles move it up or down and control tilting movements. To focus both eyes on a single target, all 6 eye muscles on each eye must work together with the corresponding muscles of the opposite eye. The brain coordinates these eye muscle movements.

Tests and Diagnosis

In infants, it is often difficult to determine the difference between true strabismus (misaligned eyes) and eyes that appear to be crossed. Young children often have a wide, flat nasal bridge and a fold of skin at the inner eyelid (epicanthal fold) that tends to hide the white sclera of the eye when looking in side gaze, thus causing the eyes to appear crossed. An ophthalmologist can readily distinguish true strabismus from the optical illusion called pseudo-strabismus which resolves spontaneously with growth during childhood development. Children should undergo vision screening by a family doctor, pediatrician, or ophthalmologist at birth, six months of age, three years of age, and pre-school to detect potential eye problems early while they can still be treated.

Treatment and Drugs

The treatment goal for strabismus is to allow for normal vision development, realign the eyes, prevent amblyopia (lazy eye), and attempt to restore stereo or 3-dimensional vision. If amblyopia is detected in the first few years of life, treatment is often successful. If diagnosis and treatment is delayed until later, amblyopia (reduced vision in one or both eyes caused by disuse) may become permanent. Occlusive patching of the better sighted eye can force use of the amblyopic eye and improve vision in the amblyopic eye. Depending on the cause of the strabismus or amblyopia, treatment may involve repositioning the unbalanced eye muscles, removing a cataract, or correcting other conditions that are causing the eyes to turn. After a complete eye examination, refraction and detailed study of the inner parts of the eye, an ophthalmologist can recommend appropriate optical, medical, or surgical treatment.

Early surgery is often recommended to correct strabismus in younger infants, who can then develop normal acuity and binocular (stereo) vision once the eyes are straightened. As a child gets older, the chance of developing normal sight and depth perception decreases. Crossed eyes can also have a negative effect on a child's coordination and motor skills, social interaction and self-confidence.

Strabismus surgery involves making a small incision in the tissue covering the eye, which allows the ophthalmologist to access the underlying eye muscles. The eyeball is never removed from the socket during this kind of eye surgery. Which eye muscles are repositioned during the surgery and by how much depends upon detailed measurement of the type of strabismus. It may be necessary to perform eye muscle surgery on one or both eyes. When strabismus surgery is performed on children, a general anesthetic is required; a local anesthetic is often an option for adults.

Eye muscle surgery is generally performed as an outpatient procedure in a hospital or a surgery center. Recovery time is rapid and the patient is usually able to resume normal activities within a few days. Following surgery, glasses or prisms may sometimes be needed to “fine tune” the result. Over-or-under correction can occur and further "touch-up" surgery may be needed. As with any surgery, eye muscle surgery has certain risks which include over or under correction of the strabismus, infection, bleeding, excessive scarring, and other complications that very rarely may lead to loss of vision.

Your Questions about Eye Muscle Surgery Answered

Christopher Gappy, M.D. , pediatric ophthalmologist, answers the most commonly asked questions about eye muscle surgery.

• Topics include:
• What is eye muscle surgery?
• What eye conditions does eye muscle surgery correct?
• What home preparations will my child follow on the day before eye muscle surgery?
• Where will my child's eye muscle surgery be performed?
• Is eye muscle surgery an out-patient procedure and is it covered by insurance?
• What are the risks of eye muscle surgery?
• How long will it take for my child's eyes to heal?

Find a Doctor or Location

• Find a doctor  
• Find a location
• Call 734-764-7558

Reviewed by Monte A. Del Monte, M.D.

Skip to content

Amblyopia (Lazy Eye)

Division of ophthalmology, what is amblyopia.

Amblyopia, also known as lazy eye or wandering eye, is a common vision problem in children. In most cases of amblyopia, your child’s brain ignores the signals coming from one eye, meaning the other eye is the only one being used.

Over time, the brain gets used to working with only one eye. The eye that’s being ignored by the brain doesn’t develop normal vision.

If treated while your child is young and the eyes are still developing, he has a good chance of overcoming amblyopia. The goal of treatment is to make your child’s brain use both eyes. Getting the eyes to work as a team becomes harder as your child grows. Early treatment is best; and treatment may not work at all if started after 7-10 years of age.

If left untreated, amblyopia may keep your child from developing normal vision.

Amblyopia affects 2-5 percent of children.

Amblyopia has three main causes:

• Strabismus , which occurs when a child’s eyes aren’t aligned (straight). The eyes don’t work together. This leads the brain to ignore one eye.
• Refractive error , or need for glasses. Children are especially at risk if one eye has larger need for glasses compared to other eye.
• Conditions that cause poor vision in one eye, like cataract or droopy eyelid (ptosis), which prompts the brain to ignore the blurry pictures seen by that eye.

Additional factors can place a child at a higher risk for amblyopia, including:

• A family history of amblyopia
• Prematurity
• Developmental delay
• Craniofacial disorders
• Certain genetic conditions, such as Down syndrome (trisomy 21) , 22q deletion syndrome , Williams syndrome and Noonan syndrome

Symptoms of amblyopia can vary from child to child, but may include:

• Squinting in one or both eyes
• Rubbing one eye (not just when tired)
• Holding items close to the eyes to see them
• A wandering or crossed eye (strabismus)

It’s important to note that some children display no symptoms of amblyopia. The child’s strong eye — and her brain — can compensate for the weaker eye, making it appear that the child has good vision.

Testing and diagnosis

Vision screening is the best way to detect presence of amblyopia or risk factors for developing amblyopia. Photoscreening, a type of vision screening that uses a special camera to determine how well a child can see, is often performed in conjunction with vision testing at pediatricians or schools.

The goal of treatment for amblyopia is to:

• Correct the problem that is causing amblyopia
• Make each eye see as well as it can, which often involves forcing the brain to use the “weak” eye
• Force the brain to use the signals from both eyes
• Make both eyes work together

Amblyopia is most often treated by blocking one eye to keep it from doing all the work. The brain can learn to accept signals from the eye that’s being ignored. Gradually, vision in this eye may improve.

Commonly used treatments include:

• An eye patch  is placed over the eye that’s being used. With this eye blocked, the brain is forced to start working with the eye it’s ignoring. The patch must be worn while your child is awake. Your child may not like wearing a patch. But remember that treatment will work only if your child wears the patch as often as instructed.
• Medicated (atropine) eye drops  can be used instead of a patch. Drops are put in the “good” eye, blurring near vision in that eye. This allows the eye that’s being ignored to start working with the brain. Eye drops may be an option for certain children who don’t like wearing a patch. But putting in eye drops can take practice.
• Eyeglasses can help correct focusing problems . They can also be prescribed to blur sight in the eye that’s being used. This forces the brain to work with the eye it’s ignoring. In some cases, sight in one eye is blocked by sticking a patch or a filter to the inside of an eyeglass lens. As vision improves, your child’s eyeglass prescription may change.

Follow-up care

Once amblyopia improves, maintenance treatment may be needed to prevent vision from slipping. Maintenance treatment includes continued wearing of eyeglasses and/or wearing an eye patch for decreasing amounts of time during the day than was required during the treatment period.

Amblyopia can cause blindness, but fortunately it is the most reversible cause of blindness. Treatment is highly successful as long as children and families stick to the treatment plan.

Reviewed by Stefanie L. Davidson, MD

Providers Who Treat Amblyopia (Lazy Eye)

William Anninger, MD

Gil Binenbaum, MD, MSCE

Stefanie L. Davidson, MD

Emily A. DeCarlo, MD

Brian j. forbes, md, phd.

Anne Jensen, MD

Priyanka Kumar, MD

Ayesha Malik, OD

Monte D. Mills, MD

Julia E. Reid, MD

Your Child's Ophthalmology Appointment

Find information to help you prepare for your child’s visit to the Division of Ophthalmology.

Preparing for Eye Surgery

Is your child having eye surgery at CHOP? Here's what you should know, from scheduling and referrals to how to prepare your child for the procedure.

Lazy eye (amblyopia)

On this page, when to see a doctor, risk factors, complications.

Lazy eye (amblyopia) is reduced vision in one eye caused by abnormal visual development early in life. The weaker — or lazy — eye often wanders inward or outward.

Amblyopia generally develops from birth up to age 7 years. It is the leading cause of decreased vision among children. Rarely, lazy eye affects both eyes.

Early diagnosis and treatment can help prevent long-term problems with your child's vision. The eye with poorer vision can usually be corrected with glasses or contact lenses, or patching therapy.

Products & Services

• A Book: Mayo Clinic Guide to Your Baby's First Years

Signs and symptoms of lazy eye include:

• An eye that wanders inward or outward
• Eyes that appear to not work together
• Poor depth perception
• Squinting or shutting an eye
• Head tilting
• Abnormal results of vision screening tests

Sometimes lazy eye is not evident without an eye exam.

See your child's doctor if you notice his or her eye wandering after the first few weeks of life. A vision check is especially important if there's a family history of crossed eyes, childhood cataracts or other eye conditions.

For all children, a complete eye exam is recommended between ages 3 and 5.

Lazy eye develops because of abnormal visual experience early in life that changes the nerve pathways between a thin layer of tissue (retina) at the back of the eye and the brain. The weaker eye receives fewer visual signals. Eventually, the eyes' ability to work together decreases, and the brain suppresses or ignores input from the weaker eye.

Anything that blurs a child's vision or causes the eyes to cross or turn out can result in lazy eye. Common causes of the condition include:

• Muscle imbalance (strabismus amblyopia). The most common cause of lazy eye is an imbalance in the muscles that position the eyes. This imbalance can cause the eyes to cross in or turn out, and prevents them from working together.

Difference in sharpness of vision between the eyes (refractive amblyopia). A significant difference between the prescriptions in each eye — often due to farsightedness but sometimes to nearsightedness or an uneven surface curve of the eye (astigmatism) — can result in lazy eye.

Glasses or contact lenses are typically used to correct these refractive problems. In some children lazy eye is caused by a combination of strabismus and refractive problems.

• Deprivation. A problem with one eye — such as a cloudy area in the lens (cataract) — can prohibit clear vision in that eye. Deprivation amblyopia in infancy requires urgent treatment to prevent permanent vision loss. It's often the most severe type of amblyopia.

Factors associated with an increased risk of lazy eye include:

• Premature birth
• Small size at birth
• Family history of lazy eye
• Developmental disabilities

Untreated, lazy eye can cause permanent vision loss.

Aug 14, 2021

• Coats DK, et al. Amblyopia in children: Classification, screening, and evaluation. https://www.uptodate.com/contents/search. Accessed June 8, 2021.
• AskMayoExpert. Amblyopia. Mayo Clinic; 2021.
• Amblyopia. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/amblyopia-lazy-eye. Accessed June 8, 2021.
• Amblyopia preferred practice pattern. American Academy of Ophthalmology. https://www.aao.org/preferred-practice-pattern/amblyopia-ppp-2017. Accessed June 8, 2021.
• Coats DK, et al. Amblyopia in children: Management and outcome. https://www.uptodate.com/contents/search. Accessed June 8, 2021.
• Diseases & Conditions
• Lazy eye (amblyopia) symptoms & causes

CON-XXXXXXXX

Your gift holds great power – donate today!

Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine.

Wandering Eye

by NSG SEO | A Child's Vision , Newsletters | 0 comments

A wandering eye is a type of eye condition known as strabismus or tropia, and it may be caused by damage to the retina or muscles that control the eye, stroke or brain injury, or an uncorrected refractive error like farsightedness. With a wandering eye, one eye deviates or wanders in a different direction when looking at an object.

What Causes a Wandering Eye?

The eyes contain muscles to which they are attached to, and these muscles receive signals from the brain that direct eye movement. Normally, the eyes work together so that they focus in the same direction at the same time. However, with a wandering eye, there is poor eye muscle control and one eye turns away from the object that the person is attempting to hone in on—either up, down, in or out. The eye that turns may do so all the time, or it may only do so at certain times, such as when the person is fatigued, sick or has overworked the eyes as a result of prolonged reading or staring at a computer. There are other cases where the eyes may alternate turning.

Because the eyes are misaligned, the brain receives a different image from each eye. While the brain will learn to ignore the image it gets from the wandering eye, if left untreated, lazy eye or amblyopia can present. This is characterized by a permanent reduction of vision in the traveling eye, and can lead to poor depth perception.

A wandering eye can be classified by the direction the eye turns:

• Inward (esotropia)
• Outward (exotropia)
• Downward (hypotropia)
• Upward (hypertropia)

It may also be classified in other ways:

• Alternating (the eye that turns alternates from left to right)
• Unilateral (always involves the same eye)
• Constant or intermittent (the regularity with which it occurs)

Testing and Treatment

To determine the classification, and in order to develop a treatment plan for a wandering eye, an optometrist will look at a number of factors to understand the cause of the condition, as well as how the eyes move and focus. This may include:

• Looking at the patient’s  family history
• Reviewing the patient’s  medical history
• Observing the external and internal structures  of the turned eye
• Refraction  – a string of lenses are put in front of the patient’s eyes and a handheld instrument with a light source is waved pass. This is done to gauge how the eyes focus and can conclude the lens power needed to correct refractive errors like nearsightedness, astigmatism and farsightedness.
• Visual acuity  – reading letters on distance or near reading charts to measure and estimate the amount of visual impairment
• Focusing and alignment testing   to determine how well your eyes move, focus and work together.

Information gathered from these assessments will help your optometrist devise a treatment plan, which could consist of vision therapy, eyeglasses, prism or eye muscle surgery. If treated early, a wandering eye can be corrected and vision can be restored.

• A Child's Vision
• Adult Strabismus
• Age-Related
• All About Eyes
• Amazing, Interesting Eyes
• Basic Visual Skills
• Changes in Appearance
• Cognitive and Acquired
• Common Eye Conditions
• Conditions That Affect Vision
• Contact Lenses
• Corneal Disorders
• Eye Diseases
• Eye Symptoms
• Glasses & Frames
• How The Eyes Work
• Injury & Irritation
• Kid's Vision
• Medical Perspectives
• Newsletters
• Pediatric Vision
• Protecting Your Eyes
• Refractive Disorders
• Retinal Disorders
• Tips for Healthy Eyes
• Uncategorized
• Vision Impairment
• Vision Problems
• Vision Therapy Programs
• Visual Rehabilitation
• We Can Help With
• What is Vision Therapy

BOOK AN APPOINTMENT

Enter your information below and a member from our team will contact you regarding an appointment.

• Full Name *
• Location : * Location North Branch, MN Cloquet, MN Duluth, MN (Grand) Duluth, MN (Kenwood) Aurora, MN Moose Lake, MN Grand Rapids, MN Two Harbors, MN Superior, WI (South Tower)
• Best Day for Appointment * Best Day for Appointment Monday Tuesday Wednesday Thursday Friday Saturday
• Reason for Appointment :
• Hidden Untitled

Claim Your Savings

• Find a Doctor
• Career Center

• Glossary Entry

Print Version- English   Print Version- Arabic

What is Amblyopia?

Amblyopia, also called “ lazy eye ,” is when one or both eyes don’t see well even with glasses. It happens when something affects how the vision develops in childhood. When you are very young, the brain learns how to see things clearly. In amblyopia, the brain gets a blurry picture from one or both eyes and so it does not learn to see well [See Figure 1]. This happens because the connections between the brain and the eye are working right. Amblyopia can often be fixed in childhood, but if not treated, it can cause permanent vision loss.  It is the main reason that kids lose vision. 

Fig. 1: Amblyopia occurs in childhood when the eye sends a blurry image to the brain that makes it hard for the brain to learn to see.

WHAT CAUSES AMBLYOPIA?

How do we know if a child has amblyopia, how is amblyopia treated, when should amblyopia be treated, when should patching be used for amblyopia treatment.

WHEN ARE EYEDROPS USED FOR AMBLYOPIA TREATMENT? 

Are there any other treatments for amblyopia, are there different types of patches.

HOW MANY HOURS OF PATCHING ARE NEEDED EACH DAY FOR TREATING AMBLYOPIA?

Do drops work for all children with amblyopia, how long does amblyopia treatment take to work, what should children be doing while patching or using eye drops for amblyopia, should patching be done in school, what if my child won’t wear the patch, can surgery treat amblyopia, what happens if amblyopia is not treated, what happens if amblyopia treatment does not work, where can i find more information on amblyopia.

Updated 1/2024

#Conditions

Related Links

Amblyopia - definition, search by....

     Eye Terms     

Eye Conditions

Translate page:

American Association for Pediatric Ophthalmology & Strabismus

1935 County Rd B2 W Suite 165 Roseville, MN 55113 Office Hours: M-F from 9am-5pm CST, please leave a voicemail or email (see below) outside of standard office hours Phone: (952) 646-2045

Find it Fast

Become a Member Patient Resources Career Center Journal of AAPOS Store

Terms and Conditions

No refunds are provided without prior approval from the AAPOS Executive Office. Please contact  [email protected]  if you would like to request a refund.   Click here to view our credit card processing security policy. © 2024 AAPOS, All Rights Reserved. Design by eConverse Media . Powered by Higher Logic .

Eugene Eye Care

Our attention is focused on you.

Conditions: Strabismus (misaligned eyes) & Amblyopia

What is strabismus.

Strabismus, although often referred to as “crossed eyes”, is actually the term used to describe any condition in which the eyes are not parallel—whether one eye turns or wanders in or out, or up or down. Strabismus may be present all the time, or it may only appear when a child is tired, ill, or concentrating on nearby objects. It may be obvious from birth, or it may not show up until later in childhood or even in adult life. Most often, strabismus is due to a persisting eye muscle imbalance.

It is not uncommon for a newborn baby’s eyes to wander. At birth, the eye muscles are not well-coordinated, but within a few weeks the infant learns to move both eyes together and the wandering disappears. However, if the condition continues beyond early infancy, prompt medical attention is needed to prevent amblyopia. Strabismus can run in families. Remember, some children can be born with strabismus and others develop strabismus as they get older.

What is amblyopia?

Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is sometimes called “lazy eye”. When one eye develops good vision while the other does not, the eye with poorer vision is called amblyopic. Usually one eye is is affected. The condition is common, affecting 4 out of every 100 people. Amblyopia can sometimes be corrected only if treated during infancy or childhood.

Although newborn infants are able to see, vision improves over the first month of life as use of the eyes increases. During early childhood years, the visual system remains in a changeable state. Vision continues to develop with proper use of the eyes. However, if the eyes are not used to capacity, visual abilities decrease. After the first eight or nine years of life, the development of the visual system is complete and cannot be changed.

Causes and symptoms of amblyopia

Amblyopia is caused by any condition that affects normal use of the eyes and visual development. There are three major causes:

• Strabismus (misaligned eyes)
• Unequal focus (refractive error)
• Cloudiness in the normally clear eye tissues.

Amblyopia occurs most commonly with misaligned eyes such as crossing of the eyes. The crossed eye “turns off” to avoid double vision, becomes lazy or amblyopic, and the child prefers the better eye. Amblyopia may also occur when one eye is out of focus because it is more nearsighted, farsighted, or astigmatic than the other. The out of focus eye “turns off” and becomes amblyopic. Sometimes, in these cases the eyes can look normal but one eye has poor vision. This is the most difficult type of amblyopia to detect and requires careful measurement of vision. An eye disease such as a cataract (see cataract on home page) may lead to amblyopia. Any factor that prevents a clear image from being focused inside the eye can lead to the development of amblyopia in a child. Children may also inherit conditions from parents that cause amblyopia. Children in a family with a history of amblyopia or crossed eyes should be examined early in life.

It is important to understand that the treatment of the condtion that causes amblyopia does NOT cure the amblyopia. After straightening the crossed eyes, correcting the blurred vision with glasses, or removing a cataract, the doctor will then treat the amblyopia separately, if amblyopia is present. Amblyopia often goes unrecognized. A child may be unaware of having one good eye and one poor eye. Unless the amblyopic child has a crossed eye or other obvious abnormality, there may be nothing to suggest the child’s condition to the parents.

Amblyopia is detected by finding a difference in vision between each eye. Since measurement of vision is difficult in young children, the doctor often estimates visual acuity by watching how well a baby follows objects with each eye when the other eye is covered. The doctor observes the responses of the baby when one eye is covered. If one eye is amblyopic and the good eye is covered, the baby may attempt to look around the patch placed over the good eye or object to the patch. Poor vision in one eye does not always mean amblyuopia is present. Vision can often be improved with glasses. However, an examination of the interior of the eye is needed to check for other disorders which may be causing decreased vision.

To treat amblyopia, the child must be forced to use the lazy eye. This is usually done by patching or covering the good eye, often for weeks or months. Part-time patching may be required over a period of years to maintain improvement even after vision has been restored. Glasses may be prescribed to correct error or imbalance in focusing. If glasses alone do not improve vision, then patching is necessary. Sometimes, amblyopia is treated by blurring the vision in the “good” eye with special eyedrops to force the child to use the amblyopic eye. If an abnormality such as a cataract is discovered, surgery is required to correct the problem causing the amblyopia. After surgery, glasses, contact lenses or other methods can be used to restore focusing along with patching to improve vision. Amblyopia is usually treated prior to surgery for strabismus (misaligned eyes) and is sometimes needed after surgery as well.

The doctor can instruct parents about how to treat amblyopia, but it is a parental responsibility to carry out this treatment. No child likes to have a good eye patched, but parents must convince their child to do what will be best for them. Successful treatment mostly depends on parental interest and involvement, and their ability to gain their child’s cooperation. In most cases, it is the parents who play an important role in determining whether their child’s amblyopia is adequately treated.

How the eyes work together

The eye works basically like a camera. The movement of the eyes up and down and from side to side is controlled by six paired muscles attached to the outside of each eye. In order to see correctly, both eyes must face or turn together in the same direction. This is accomplished by teamwork: When the eyes turn, one muscle pair pulls, while another pair relaxes. The muscles are positioned in such a way that the eyes can move in all directions. To see correctly, both eyes must look at the same object at the same time. Each eye sees it from a slightly different angle, and each eye sends a slightly different picture to the brain. The brain takes these two pictures and blends them into one three-dimensional image. This brain fuction is called “fusion” and helps us to have depth perception or the ability to judge the relative distances between objects.

Sometimes, the eye muscles are not coordinated. The result is that the eyes cannot work as a team. If one eye is looking directly at an object while the other turns in or out, the image that the straight eye sends to the brain will be clear, but the image from the wandering eye will be blurry. Try as it might, the brain can’t blend these two images into one image (double vision). The child quickly and unconsciously learns to ignore the blurred image seen by the wandering eye (suppression). The result is that the stronger eye takes over most of the work of seeing and the weaker eye grows “lazy” (amblyopia) from lack of use.

My child doesn’t like to wear the patch!

Since the patch covers the good eye, your child will have trouble seeing at first. Naturally, many children try to take the patch off. This usually disappears as soon as the childs gets used to wearing the patch. You may be tempted to give in to an unhappy child, but remember that every time your childs remvoes the patch, effective treatment is delayed. You can help by being inventive. Some parents have found that if they wear a patch for the first few days, the child will wear one too. Try decorating the patch with a colorful design. Organize a game of pirates with your child as the captain or have family patch day. Patching their favorite doll, car toy, etc. can be helpful. Some children respond well to postive reinforcement rewards such as sticking gold stars on a chart each day the patch is worn.

For more information about joining “The Eye Patch Club”, see Prevent Blindness America by clicking here .

Most children are farsighted but most children don’t wear glasses. This is because children have a remarkable ability to focus their eyes to correct the farsightedness themselves. One of the side effects of this excessive focusing abilty is the eyes tendency to turn inward much like the eyes normally cross inward slightly when looking at a very near object. In a farsighted child with crossed eyes, the glasses prescribed are not necessarily to improve vision but rather to relieve the eye of this focusing and secondarily decrease this tendency for the eyes to cross inward. Rather than the eye doing the focusing and causing the eyes to turn inward, the glasses relieve the eye muscles and the eyes are allowed to straighten. Sometimes glasses alone will successfully straighten the eyes. Sometimes, glasses will only partially straighten the eyes and surgery will be needed. In the case of amblyopia, patching may be used as well as glasses. Remember that glasses for the farsighted child are given to straighten the eyes, not necessarily to improve vision. They must be worn full time to be effective. Farsightedness often decreases with age and the child will likely need weaker and weaker glasses as they get older. Sometimes, glasses are not needed by the time the child is a teenager. However, if glasses are precribed to correct nearsightedness or astigmatism, they may always be needed to help the child focus.

Surgery is sometimes needed along with glasses and patching. The surgery has been shown to be safe and effective. By adjusting the tension of the outer muscles on one or both eyes, the eyes can be straightened. If surgery is done on an older child, the eyes can be made straight, but fusion will probably not be achieved. A small incision is made in the outer covering of the eye where the muscles are attached. The eye muscles are either weakened or strengthened with tiny stitches that eventually absorb and do not need to be removed. The child is usually very comfortable after surgery. Pain pills etc. are usually not required and no patches are used for the surgery itself. The average surgery might take 30-45 minutes. One operation usually fixes the problem. However, the amount of correction that is just right for one child may be too much, or too little, for another. It is always possible that more than one operation may be needed. If glasses were needed before surgery, most likely they will still be needed after surgery. Surgery will help straighten your child’s eyes, but it is only one tool of treatment, not a complete cure. Sometimes, patching for amblyopia is also necessary after surgery.

Why can’t my child have surgery instead of wearing glasses?

Surgery is intended to correct only the amount of strabismus that glasses won’t take care of. Remember that your child’s eyes will be developing further, and that glasses for farsightedness will probably not be needed years from now. If too much surgery is performed at a young age, by the time your child is a teenager, the eyes could begin to turn the opposite way.

992 Country Club Rd., Suite 101 Eugene, Oregon 97401 | Map

Ph: 541-687-1715 Fx: 541-687-1690

In Springfield

1110 18th St, Suite 3 Springfield Oregon 97477

Ph: 541-726-6447

In Cottage Grove

315 S Goshen-Divide Hwy Cottage Grove Oregon 97424

Ph: 541-942-0176

2021 Update: Lazy Eye and Adults

Lazy eye is estimated to affect up to 5% of all adults.

For many decades, it has been thought that only children under the age of 10 could be successfully treated for amblyopia (lazy eye). In other words, lazy eye treatment was usually not provided to children older than nine.

However, the National Eye Institute (NEI) recently funded a study that found that lazy eye can be successfully treated at least up to age 17 and even adults!

Now, lazy eye can be effectively treated in high school and college student and even adults !

What is lazy eye?

Lazy eye, also known as amblyopia, is a neuro-developmental vision condition that is caused when one eye is unable to achieve normal visual acuity or does not allow the full development of 3D vision.

A lazy eye typically affects the vision or visual function of the affected eye, causing blurred vision which contributes to poor depth perception and binocular vision.

Amblyopia may develop due to other vision conditions such as a wandering or crossed eye (strabismus), or unequal vision in the two eyes caused by nearsightedness, farsightedness or astigmatism.

Contact an eye doctor near you who can diagnose and treat your lazy eye.

Symptoms of lazy eye

Common symptoms of lazy eye:

• One or both eyes may wander inward or outward
• Both eyes may not seem to be working together
• Poor depth perception
• Squinting or shutting one eye in order to see
• Tilting one’s head in order to see
• Frequent eye strain, eye fatigue, or headaches

If you experience any of these symptoms, contact an eye doctor near you who diagnoses and treats lazy eye.

Schedule an appointment with a vision therapy eye doctor to help improve your visual skills .

SEE RELATED: New Research for Adults with Lazy Eye

Find a Vision Therapy Eye Doctor Near You

Are eye exams important.

Yes, frequent eye exams are essential as the earlier a lazy eye is detected, the higher the chances of successful treatment.

In many cases, amblyopia is detectable during a comprehensive eye exam. In addition, if there is a family history of lazy eye, it is crucial that your eyes be examined regularly, as lazy eye can be an inherited condition.

Specific tests are used during eye exams to assess both the visual acuity and the visual skills of each eye. This enables your eye doctor to diagnose a condition such as lazy eye.

Adult lazy eye treatment

For many years it was believed that amblyopia was only treatable in children, often those who are 10 years of age or younger. However, this isn’t necessarily the case. While every patient is different, many adults can see results from amblyopia treatment.

The visual system which consists of the brain, eyes, and visual pathways, can be retrained due to the brain’s plasticity.

For amblyopia , specifically, binocular vision needs to be retrained, as this is the root cause behind a lazy eye. 

With poor binocular vision the two images that the eyes see cannot be combined into one single image, but due to the plasticity of the brain, this does not have to be permanent.

While treatment is most effective when it’s given at an early age, it is still possible at any age to retrain the visual system, restore binocular vision, and correct amblyopia.

Lazy eye and vision therapy

Vision therapy is an effective treatment method for amblyopia. It has been shown to greatly improve the visual skills of the lazy eye by re-training the visual system.

Through vision therapy, the two eyes will be trained to work together to achieve clear and comfortable binocular vision.

Some vision therapy programs that treat amblyopia work to improve these visual skills:

• Accommodation (focusing)
• Fixation (visual gaze)
• Pursuits (eye tracking)
• Saccades (switching eye focus, “eye jumps”)
• Spatial skills (eye-hand coordination)
• Stereopsis (3-D vision)

LEARN MORE: Guide to Vision Therapy for Adults

Schedule an eye exam and vision evaluation for a proper diagnosis of lazy eye and to discuss whether a vision therapy program is the appropriate treatment for you.

Find an Eye Doctor

Your plain English library for vision therapy, children's vision, neuro-optometry, and primary eye care.

Vision Therapy

• Guide to Vision Therapy
• For Children
• For Learning Difficulties
• For Lazy Eye
• Neuro-Optometry

Children’s Vision

• Vision for School
• Vision for Special Needs
• Visual Development
• Pediatric Eye Conditions
• Children’s Eye Exams

Primary Eye Care

• Binocular Visual Dysfunction
• Myopia Management
• Eye Conditions
• Sports Vision
• Optical and Contacts

Looking for an Eye Doctor?

Have an optometry practice.

Join the Network

© 1996-2024 Optometrists Network - Powered by EyeCarePro - 70 North Meadow Crescent, Thornhill ON L4J 3B1, Canada

• LASIK Pricing
• Eye Conditions
• Refractive Errors
• Vision Education
• Eye Doctors
• LASIK Eye Surgery
• Cataract Eye Surgery
• Laser Eye Surgery
• Photorefractive Keratectomy (PRK)
• SMILE Eye Surgery
• Blue Light Glasses
• Colorblind Glasses
• Polarized vs. Non-Polarized Sunglasses
• Gaming Glasses
• Other States

Home / Eye Conditions & Diseases / Amblyopia

Refractive Amblyopia: Everything You Need to Know

Risk factors, treatment options, complications.

• Adults vs. Children
• Frequently Asked Questions

Amblyopia, or lazy eye, is a medical condition that makes it difficult to see clearly through one eye because of abnormal development of that eye during childhood. The condition results in a wandering eye. 

What causes of amblyopia is a refractive error in the bad eye, either nearsightedness, farsightedness or astigmatism.

Amblyopia is a medical condition that makes it difficult to see clearly through one eye because of abnormal development of that eye during childhood. The condition results in a wandering eye or lazy eye. 

Individuals with lazy eye depend heavily on their normal eye to see, while the weaker (amblyopic) eye will worsen over time from lack of stimulation from the brain. There are three types of amblyopia:

• Refractive amblyopia
• Strabismic amblyopia
• Deprivation amblyopia

Refractive amblyopia is the most common type of amblyopia , especially among young children. Refractive errors cause this type, and the errors make it difficult for light to get focused correctly on your eye, making objects appear blurry.

The two types of refractive amblyopia that can affect your eyes include:

• Isoametropic amblyopia
• Anisometropic amblyopia

Refractive amblyopia usually occurs because of one of several refractive errors. Among them:

• Nearsightedness , where you only see nearby objects clearly.
• Farsightedness , nearby objects appear blurry.
• Astigmatism , the irregular shape of your eye’s lens.

The lens is the clear part that helps focus an object’s light on your eye. Depending on how they affect your eyes, errors will cause either anisometropic or isoametropic refractive amblyopia. 

Anisometropic Amblyopia

With this condition, one eye is significantly more affected by refractive errors than the other, so your eyes will not focus on objects equally. It occurs primarily because of hyperopia (farsightedness) but can also happen because of unequal amounts of myopia (anisomyopia) between your eyes.

Isoametropic Amblyopia

In this case, your eyes have the same high levels of refractive errors. Isoametropic amblyopia occurs primarily if your eyes are affected by high levels of farsightedness .

Symptoms of Refractive Amblyopia

Refractive amblyopia rarely presents with symptoms. Some children might not even know they have it until the doctor examines their eyes. But the symptoms will be more or less the same as that of the other types of amblyopia. They are:

• Depth perception difficulty in viewing objects from three dimensions. You cannot judge the distance of an object accurately.
• A head tilt , with the positioning of the head is one particular angled position so that you can see clearly.
• Eyes turn in or out
• Convergence insufficiency: , making your eyes unable to collaborate when focusing on an object
• Poor vision in the affected eye

Having refractive errors usually increases your chances of getting refractive amblyopia. Some other non-eye related risk factors also increase the risk, including:

• Smoking during pregnancy
• Premature birth
• Children with an APGAR score of less than 7
• Refractive amblyopia family history

To be successful, treatment of refractive amblyopia must begin early, especially in children. Take your child to the eye doctor immediately when you suspect that they have amblyopia to avoid complications.

Children are more responsive to treatment options of eye patches, eye drops and eyeglasses.

Eye Patches

The standard way of treating refractive amblyopia is using an eye patch . Covering the good eye with a patch will force the brain to interpret images from the amblyopic eye, strengthening the connection. Eye doctors advise that you wear the patch for at least two hours a day.

Atropine Eye Drops

The eye doctor can use the drug Atropine as an alternative to an eye patch. Atropine reduces the abilities of the good eye to focus on near objects. Both eyes will have a certain level of refractive error, making the brain stop favoring one eye over the other.

The drug is more convenient than eye patches. However, the drug has its drawbacks because it may not work for people who have resistance to eye drops. It can also have some side effects, such as light sensitivity.

Eyeglasses are another commonly used method for correcting refractive amblyopia. Glasses work by correcting the refractive errors causing amblyopia. 

Leaving refractive amblyopia untreated leads to irreversible complications such as:

• Children with learning and reading difficulties
• Problems related to visual function, such as visual acuity
• It can cause blindness in some instances
• Serve strabismus (crossing of eyes)

Refractive Amblyopia in Adults vs. Children

Refractive amblyopia is usually associated with young children. However, there are some reported cases among adults as well. Adults develop the condition because of a failure to correct it when they were young. 

Unlike in children, refractive amblyopia causes a permanent reduction in vision among adults. Adults also respond differently to children when using refractive amblyopia treatments. Vision therapy is the best lazy eye treatment for adults.

Can refractive amblyopia be corrected?

Yes. There are different treatment methods for refractive amblyopia. These procedures aim at correcting the refractive errors causing amblyopia. The standard treatment methods are eye patches, eyeglasses, and atropine eye drops. 

Is refractive amblyopia a disability? 

Not necessarily. If you notice that you have refractive amblyopia and treat it promptly, you will avoid any vision-related problems. Notably, if you leave it untreated, some visual disabilities such as blindness can result.

Can refractive amblyopia get worse?

Yes, it can get worse. Refractive amblyopia is less severe, and you may not notice it during your childhood days. But if left untreated, it can get worse, causing further complications to your eyes.

Amblyopia . (January 2021). American Association for Pediatric Ophthalmology & Strabismus.

Prevalence of Amblyopia and Refractive Errors Among Primary School Children . (October 2015). Journal of Ophthalmic & Vision Research.

Types of Amblyopia . (October 2015). American Academy of Ophthalmology.

Amblyopia . (Feb 2022). Medline Plus.

Squinting Eyes And Tilts Head To Look At Something . (May 2020). MedicineNet.

Prevalence and Risk Factors of Amblyopia among Refractive Errors in an Eastern European Population . (2018 March). Medicina Kaunas.

Anisometropic Amblyopia . (December 2021). American Academy of Ophthalmology.

Isoametropic amblyopia due to high hyperopia in children . (August 2004). Journal of the American Association for Pediatric Ophthalmology & Strabismus.

Extended daily eye patching is effective at treating stubborn amblyopia in children . (September 2013). National Eye Institute.

Altropine sulfate, Statistical Review and Evaluation . (October 2013). U.S. Food and Drug Administration.

Compliance, patching, and atropine amblyopia treatments . (September 2015). Vision Research.

Lazy eye (amblyopia) in children: What are the treatment options for lazy eye (amblyopia)? (June 2020). InformedHealth.org.

Amblyopia . (January 2022). StatPearls.

Amblyopia . (Retrieved March 2022). New York City Health.

Last Updated March 24, 2022

Note: This page should not serve as a substitute for professional medical advice from a doctor or specialist. Please review our about page for more information.

• Eye Boogers
• Eyelid Eczema
• Shingles on Face
• Cloudy Vision in One Eye
• Get Rid of Puffy Eyes
• Exotropia (Eyes Turning Outward)
• Xanthelasma
• What Causes High Eye Pressure

Pediatric Eye Care

Strabismus / Wandering Eye Treatment (Children)

Treatment of wandering eye in children.

Normally, the eyes work as a team, aiming at the same spot, providing the brain with the information it needs to create a three-dimensional image.  This three-dimensional image is what gives a person the depth perception which helps us in so many daily activities in work, play, and sports.  Strabismus means that the two eyes point at different spots (that is in different directions) and the brain sees two different images which cannot be combined, or fused, into a single image.  In young children, the brain will then ignore or turn off the image in one eye or the other to prevent confusing double vision.  Older people with a new strabismus may be unable to ignore (or suppress) an image and will see double.

Almost half of the strabismus we see at the Spokane Eye Clinic can be treated with glasses, prisms, exercises, and patching.  It is important to line the eyes up as early as possible so that the brain can develop the best ability to combine or fuse the images of the two eyes into one picture.  So if these techniques are not effective surgery will usually be recommended.

Strabismus Surgery

Modern strabismus surgery is done in an outpatient setting and is minimally invasive.  The Ophthalmologist makes a small incision in the tissue covering the white of the eye to reach the eye muscles.  Each human eye has six muscles, responsible for moving it in various directions, and typically the surgeon repositions one or more of these muscles, in one or both eyes, to bring the eyes into alignment.  Once aligned, the eyes can move together as intended, sending images back to the brain which may be fused into one three dimensional image. This is done in the safety of an operating room with general anesthesia providing complete comfort to the patient.

Recovery time is rapid.  Most normal activities can be resumed within a few days.  After surgery glasses, sometimes with prisms, and sometimes exercises or patching may be helpful "fine tune" alignment.  Further surgery at a later time is often needed to keep the eyes in good alignment.

As with any surgery, eye muscle surgery has some risks.  These include infection, bleeding, excessive scarring, and very rare cases of vision damaging complications.  Usually, strabismus surgery is safe and effective.

Ocular Torticollis

Torticollis is a persistent tipping and or turning of the head, and when it is done to prevent double vision or blurring it is called ocular torticollis.  The two most common causes are nystagmus, which is a rhythmic back and forth eye jerking, and some forms of strabismus where the alignment if the eyes is better in some directions or head positions.  Modern eye muscle surgery can reduce nystagmus and improve the head position in many cases.  Similarly, with careful diagnostic measurements of all of the eye muscles, the ophthalmologist can design strabismus surgery to improve the imbalances between muscles, so that the head tilt or turn is no longer necessary to achieve single vision.  As with any eye muscle surgery, it is outpatient with rapid recovery being usual.  Glasses, often with a small amount of prism, may enhance the results of surgery.

To schedule an appointment, call (509) 456-0107

Help Keep Our Community Safe!

Here are some things to expect as you visit any of our clinics.

Clinic Hours : 7 am to 5 pm

Optical hours : 8 am to 5 pm, surgery center hours : 7 am to 5 pm, stay home if you are sick.

Stay home if you are sick; prevent the spread of illness.

Prepare To Wait

Please prepare for at least two hours for routine or medical eye exams. Sometimes it takes a little longer to give each patient quality care, and we hope you understand.

Any Questions?

Someone is available to answer your questions Monday through Friday, 7 AM to 5 PM, at 509-456-0107.

How to “See” If Your Partner Only Has Eyes for You

Cultivate an eye for a wandering eye by understanding how gaze matters..

Posted March 30, 2019 | Reviewed by Lybi Ma

You have just been seated at a trendy new restaurant and are eager to begin an evening of great food and great conversation. You don't need to look at the menu—you chose your entrée on the restaurant website days ago. Your date doesn't look at it either—apparently for a very different reason. He doesn't look at you either; his gaze is focused on another woman seated nearby at the bar. Given that this is your first night out together, does his focus (or fixation) indicate he is being obvious or oblivious?

Does Other-Focus Indicate Distraction or Attraction ?

If you have ever been in this situation, out with someone who seems to notice everyone but you, know that you are in good company. Although it is hard not to take personally, most people have found themselves in this awkward predicament at one time or another, wondering what to do, whether to say something, or how to best get through the evening.

Whether you are out to dinner, a ballgame, or any other public outing, partner inattention can range from distraction to fixation. A “date” who is engaging in embarrassing staring and ogling of relational alternatives is the easy case, where clearly the first date is the last. The more challenging scenarios involve subtle glances, lingering eye contact with others, or other types of ambiguous behavior where you worry your suspicions reflect your own insecurity rather than the intentions of your partner.

Particularly with couples whose primary method of interaction has been online, a failure to connect visually on a first date is unnerving. This is because eye contact during the getting-to-know-you phase of a relationship is very important. There may be cultural explanations and social rules that explain visual behavior in many cases. In others, research shows that fixation reveals motivation .

Gaze research has focused on the link between looking and thinking, and accordingly reveals some suggestions for discerning the objectives behind the optics.

Gaze Reveals Interest: Where Do You Look?

When it comes to attraction, where you look might reflect what you are thinking. Omri Gillath et al. (2017) studied the correlation between eye movements and interest when looking at photographs of potential friends versus romantic partners. 1 They found that when assessing romantic suitability, people looked more at the head and chest. When assessing potential friends, on the other hand, they looked more at the feet and legs.

Does relationship status make a difference? Gillath et al. found that in general, singles looked at the photographs longer than people in relationships, especially when judging potential mates.

Regarding gender differences, they found that women interested in friendship looked more at the head, as opposed to men, who looked at the head when they were less interested in friendship.

In explaining their findings and possible implications, they noted that people are “visual creatures,” using the sense of sight more than any other sense to interpret surroundings. They also note that both friendship and romance are anchored in attraction. Their research emphasized that the way we regard each other differs based on both our gender and relational goals.

Attraction and Social Comparison

Attraction also involves an element of social comparison. One phenomenon that has been tested through research is the fact that in a dating context, people not only size up each other, but the competition .

Research reveals how women consider social comparison by measuring photograph viewing time. In a study involving showing heterosexual men and women photographs of individuals in bathing suits, Yin Xu et al. (2016) found the men to be more gender-specific in viewing time patterns. 2

They found that with women, however, social comparison attention played a role. While the viewing time of men was only associated with ratings of sexual attractiveness , women viewing photographs of other women were associated with both self-reported sexual attractions and physical appearance social comparison.

Obviously, all women are different, and these results will not apply to everyone. But this is one example of how attention does not necessarily indicate intention. There are different factors that explain why we look at someone longer than our partner might like—when he or she does not understand the reason for our lingering gaze.

The Eyes Have It: Windows to the Soul

Understanding the range of possible explanations for visual behavior is important—but should be interpreted in context. Culture, social conditioning, insecurity, and a wide range of other factors may be at play. Hence the necessity of moving slowly and getting to know the person behind the gaze. If the eyes are the windows to the soul, you want to become acquainted with the character beneath the physical characteristics.

1. Omri Gillath, Angela J. Bahns, and Hayley A. Burghart, ”Eye Movements When Looking at Potential Friends and Romantic Partners,” Arch Sex Behav 46 (2017): 2313-2325.

2. Yin Xu, Qazi Rahman, and Yong Zheng, “Gender-Specificity in Viewing Time Among Heterosexual Women,” Arch Sex Behav 46 (2017): 1361-1374.

Wendy L. Patrick, J.D., Ph.D., is a career trial attorney, behavioral analyst, author of Red Flags , and co-author of Reading People .

• Find a Therapist
• Find a Treatment Center
• Find a Psychiatrist
• Find a Support Group
• Find Teletherapy
• United States
• Brooklyn, NY
• Chicago, IL
• Houston, TX
• Los Angeles, CA
• New York, NY
• Portland, OR
• San Diego, CA
• San Francisco, CA
• Seattle, WA
• Washington, DC
• Asperger's
• Bipolar Disorder
• Chronic Pain
• Eating Disorders
• Passive Aggression
• Personality
• Goal Setting
• Positive Psychology
• Stopping Smoking
• Low Sexual Desire
• Relationships
• Child Development
• Therapy Center NEW
• Diagnosis Dictionary
• Types of Therapy

Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.

• Coronavirus Disease 2019
• Affective Forecasting
• Neuroscience

• Skip to main content
• Keyboard shortcuts for audio player

Solar eclipse 2024: Follow the path of totality

Solar eclipse, worried about eclipse damage to your eyes don't panic.

Geoff Brumfiel

Nell Greenfieldboyce

Junior Espejo looks through eclipse glasses being handed out by NASA in Houlton, Maine. Used correctly, eclipse glasses prevent eye damage. Joe Raedle/Getty Images hide caption

Junior Espejo looks through eclipse glasses being handed out by NASA in Houlton, Maine. Used correctly, eclipse glasses prevent eye damage.

Tens of millions of Americans will have spent the day staring at a total solar eclipse, and at least a few of them may become worried that they inadvertently damaged their eyes.

But experts say there's no need to panic — the vast majority of eclipse viewers are probably fine. And even if somebody did strain their eyes, the effects could be temporary.

During the 2017 total solar eclipse it's estimated that 150 million Americans viewed the event. There were around 100 documented cases of eye damage across all of America and Canada, according to Ralph Chou, an expert on eclipse eye safety with the University of Waterloo in Canada.

Far more people turned up in emergency rooms worried that they'd damaged their eyes. Many complained of watery eyes or blurred vision, but in most cases they were fine, according to Avnish Deobhakta, an ophthalmologist at the New York Eye and Ear Infirmary of Mount Sinai, one of the largest eye hospitals in the nation.

The reason it's hard to do real damage is simple — the human eye has evolved to avoid staring directly at the sun.

"It's so bright that we're not actually capable of looking at it without either tearing or sort of not really feeling comfortable staring at this ball of light," Deobhakta says.

Shots - Health News

Here's what it looks like when you fry your eye in an eclipse.

In the rare case that someone does damage their eyes, that damage usually shows up as a blurry spot in the field of vision , hours or up to a day after watching the eclipse. In about half of cases, the problem fixes itself, but permanent damage can sometimes occur.

Anticipating the post-eclipse ocular anxiety, at least one eye clinic in Buffalo, N.Y., is offering free eye checks immediately after the eclipse on April 8.

It's always a good idea to get your eyes checked, whether or not there's an eclipse. So if you're worried at all, go ahead and use the opportunity to schedule your annual exam.

• eclipse eye damage
• 2024 eclipse

• Bipolar Disorder
• Therapy Center
• When To See a Therapist
• Types of Therapy
• Best Online Therapy
• Best Couples Therapy
• Best Family Therapy
• Managing Stress
• Sleep and Dreaming
• Understanding Emotions
• Self-Improvement
• Healthy Relationships
• Student Resources
• Personality Types
• Guided Meditations
• Verywell Mind Insights
• 2023 Verywell Mind 25
• Mental Health in the Classroom
• Editorial Process
• Meet Our Review Board
• Crisis Support

How to Deal With a Partner Who Has Wandering Eyes

Sheri Stritof has written about marriage and relationships for 20+ years. She's the co-author of The Everything Great Marriage Book. 

Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.

Signs of a Wandering Eye

Differing viewpoints.

• Impact of Social Media
• Have You Crossed a Line?

How to Respond

When a person has a 'wandering eye,' it means looking and having sexual thoughts about people other than their current romantic partner. It may include behaviors such as overtly evaluating and appreciating someone's physical attractiveness or even outright flirting with people who are not their romantic partners.

When the issue of a partner's eyes wandering is discussed, there seem to be two general responses: Either the behavior is brushed off as nothing to be concerned about or feelings of hurt and disrespect ensue, which may harm the relationship .

Some even believe checking out people other than a committed partner is a sure sign of infidelity, or at least a form of micro-cheating . The true answer to whether or not this is OK lies with you, your needs, and your personal boundaries .

It is important to recognize that each person has differing definitions depending on their beliefs and boundaries. Some examples of behaviors that characterize a wandering eye include:

• Blatantly checking out another person
• Flirting with other people
• Having sexual fantasies about others
• Talking about sexual fantasies about other people
• Telling other people they are attractive
• Planning romantic or sexual encounters with people other than their partner
• Texting or DMing people other than their partner

The behaviors that characterize a wandering eye involve how a person thinks about or communicates with people other than their partner. If these thoughts or actions lead to romantic or sexual encounters, it would be defined as cheating .

According to  Gail Saltz, M.D ., a psychiatrist and expert on relationship matters, blatantly checking out, commenting on, repeatedly admiring, and flirting or touching someone else usually feels quite undermining to a partner.

For partners that are bothered by the behavior, having wandering eyes is often described as:

• A sign of disrespect
• Damaging to a relationship
• Insensitive behavior that shows a lack of caring
• One of the first signs of cheating and that a person is looking for another relationship

Dr. Saltz acknowledges that all humans have some measure of voyeurism and exhibitionism: we like to look and we like to show.

But unless both parties are confident of the others' affection and fidelity, an obvious and frequent wandering eye will generally stir up envy and hurt, making one feel unappreciated and even threatened in the relationship.

On the other hand, some people believe that having a wandering eye is perfectly normal behavior. People in this camp often don't worry about a quick glance, and some may not even be bothered by something more.

Those who feel this way often cite the following points:

• Looking at an attractive person is thought to be a natural physiological reaction.
• A person with wandering eyes just appreciates beauty.

Again, it's important to remember that you define what is normal and acceptable for yourself and your relationship. That said, a study published in the  Journal of Personality and Social Psychology found that a consistent wandering eye probably signals a more significant issue in a relationship, which is worth considering.

Some evidence suggests that people prone to having a wandering eye are also more likely to engage in infidelity. One study found that people who found attractive people more attention-grabbing were more likely to eventually cheat on their partners.

Impact of Social Media and Technology

People don't just engage in 'wandering' behaviors in real-world encounters. They can also make their way into online interactions. In such settings, 'wandering' might involve:

• Flirting with another person, either in the comments section on their social media post or via direct message
• "Liking" another person's photos to communicate interest
• Flirtatious, romantic, or sexual texting with people who are not the person's partner
• Intentionally joining social sites in order to engage in flirtatious communication with others

Such behaviors can affect trust, communication, and intimacy in a relationship. According to one survey, around a quarter of people in relationships feel that technology has had a negative impact on their relationships.

Have You or Your Partner Crossed the Line

It isn't always easy to determine if you or your partner have crossed a boundary in your relationship. This is because it is normal to think that other people are attractive and doing so doesn't necessarily mean that you've broken trust with your partner.

In order to recognize whether you or your partner have a wandering eye, consider the following:

• How would your partner feel if they knew about your behaviors?
• How would it make you feel if your partner was doing the same thing?
• Have you ever discussed boundaries with your partner?
• Does your current behavior violate your partner's trust?
• Are you hiding your behavior from your partner?

If you feel like your partner would be hurt or upset and need to hide your actions from them, it is a good sign that your actions are crossing the line. 

If you are bothered by your partner's eyes wandering, Dr. Saltz suggests that you make it clear that although you don't expect them to wear blinders, you don't want them to ogle someone else.

If your partner really won't make any effort to change and doesn't appear to care how it makes you feel, it's likely that other issues may be affecting your relationship that couple's therapy could help examine.

Indeed, it seems that research agrees with this advice. The aforementioned study goes on to say that nagging your partner to stop looking likely won't address any underlying problems, either. Your relationship will require communication and a strategy to boost satisfaction and commitment.

Leading with jealousy and sweeping requests for your partner to change his or her behavior may lead them to tune you out. Instead, Dr. Saltz suggests the following:

• Accept that your partner's wandering eye is not a reflection of your own attractiveness.
• Don't try to "police" your partner's wandering eyes.
• If your partner's wandering eye creates a problem in your relationship, discuss the issue with them. Start with your own feelings, not with an accusation or criticism. 
• Suggest couple's therapy or attend therapy on your own if your requests are continually ignored.
• Try to casually acknowledge it first when a beautiful person comes into view.

A Word From Verywell

A wandering eye could very well be a natural, simple acknowledgment of attractive people—nothing more. Of course, that may not be the case all the time. Regardless, your feelings should be valid to your partner. If it bothers you and you have calmly expressed as such to your partner, he or she should be receptive to your concerns.

DeWall, CN, Maner, JK, Deckman, T, Rouby, DA. Forbidden fruit: inattention to attractive alternatives provokes implicit relationship reactance . J Pers Soc Psychol . 2011;100(4), 621–629. doi:10.1037/a0021749

McNulty JK, Meltzer AL, Makhanova A, Maner JK. Attentional and evaluative biases help people maintain relationships by avoiding infidelity .  J Pers Soc Psychol . 2018;115(1):76-95. doi:10.1037/pspi0000127

Pew Research Center. Couples, the internet, and social media .

American Association for Marriage and Family Therapy. About marriage and family therapists .

Dewall CN, Maner JK, Deckman T, Rouby DA. Forbidden fruit: Inattention to attractive alternatives provokes implicit relationship reactance .  Journal of Personality and Social Psychology . 2011;100(4):621-629. doi:10.1037/a0021749

By Sheri Stritof Sheri Stritof has written about marriage and relationships for 20+ years. She's the co-author of The Everything Great Marriage Book. 

Watch CBS News

Did you look at the solar eclipse too long? Doctors explain signs of eye damage

By Sara Moniuszko

Edited By Allison Elyse Gualtieri

Updated on: April 8, 2024 / 3:42 PM EDT / CBS News

Did you look up at the solar eclipse without your safety glasses ? Looking at the sun — even when it's partially covered like during the eclipse on April 8 — can cause eye damage.

There is no safe dose of solar ultraviolet rays or infrared radiation, said  Dr. Yehia Hashad , an ophthalmologist, retinal specialist and the chief medical officer at eye health company Bausch + Lomb.

"A very small dose could cause harm to some people," he said. "That's why we say the partial eclipse could also be damaging. And that's why we protect our eyes with the partial as well as with the full sun."

But how do you know if you've hurt your vision? We asked eye doctors what to know.

Is it a sign of eye damage if your eyes hurt after looking at the eclipse?

Your eyes likely won't hurt if you look at the eclipse without protection — but that doesn't make it any less dangerous.

In fact, the painlessness is part of why the event is so concerning to eye care professionals, said Dr. Jason P. Brinton, an ophthalmologist and medical director at Brinton Vision in St. Louis. 

"Everyone knows don't look at the sun. If you go out on a bright day and try to look at the sun — it's very uncomfortable, very bright. So most people intuitively associate that with something they should not be doing," Brinton said. "But with the eclipse, so much of that is blocked and so that natural sense of discomfort and aversion to the brightness is not there."

In some cases, the sun can also damage the cornea, which can be painful, Brinton says.

"The good news is that this fully heals without lasting issues, so this is why we don't think about this aspect as much. The retinal issues, on the other hand, are painless and can have permanent, lasting effects on vision," he said.

What are other signs of eye damage from looking at a solar eclipse?

Hashad says there are a few "alarming signals" to be aware of, including: 

• Blurred vision
• Scotomas, or dark spots: "You just see a black area or a black spot in the field of vision," Hashad said. 
• Color changes:  "You don't see the colors the same way you were seeing it before," he said.
• Distorted lines:  Hashad says this is clinically known as metamorphopsia, which makes lines appear warped, distorted or bent.

"This could be happening unilateral or bilateral," he said. "So it doesn't necessarily happen in both eyes. It could be affecting one over the other or both eyes together."

Issues may not be apparent immediately, either, sometimes appearing one to a few days following the event.

And while some will regain normal visual function, sometimes the damage is permanent. 

"Often there will be some recovery of the vision in the first few months after it, but sometimes there is no recovery and sometimes there's a degree to which it is permanent," Brinton said. 

What should you do if you show symptoms of eye damage?

If you're experiencing any symptoms of eye damage, Hashad suggested people "immediately" seek an ophthalmologist's advice.

"Seeing an eye care professional to solidify the diagnosis and for education I think is reasonable," Brinton said. 

Unfortunately, there isn't a treatment for solar retinopathy, the official name for the condition.

"Right now there is nothing that we do for this. Just wait and give it time and the body does tend to heal up a measure of it," Brinton explained.

That is why prevention is so important, and remains the "mainstay of treatment of solar retinopathy or solar damage to the retina," Hashad explained. 

How long is too long to look at a solar eclipse without glasses?

Any amount of time looking at the solar eclipse without glasses is too long, experts said.

"Damage from the solar eclipse could happen to the retina in seconds," Hashad said. "That's why we don't want people to stare even for a short period of time — even if for a few seconds to the direct sun — whether eclipsed or even partially eclipsed."

Sara Moniuszko is a health and lifestyle reporter at CBSNews.com. Previously, she wrote for USA Today, where she was selected to help launch the newspaper's wellness vertical. She now covers breaking and trending news for CBS News' HealthWatch.

More from CBS News

Arizona's abortion ban likely to cause people to travel to states it's still legal

Meta tests new features on Instagram designed to fight teen sextortion

Guide dog nicknamed Dogfather retires after fathering over 300 puppies

Best places to buy patio furniture online