Strabismus in Infants

by Dr. Moshe Ipp

Newborns Often Seem To Cross Their Eyes. By What Age Should This Be Considered Abnormal? When Should We Be Concerned About Amblyopia Developing In Strabismus In Infants?

Infants normally seem to cross their eyes until about three months of age. If they are still crossing their eyes by three to six months of age this is abnormal and they should be seen by an opthalmologist for an assessment. The question asked is an important one because half of all children with strabismus may develop amblyopia and approximately one third of all children with amblyopia will also have strabismus. Since amblyopia may occur in children without any obvious signs (in fact one observer has aptly described the condition as one in which "the physician sees nothing and the patient sees very little"), routine visual acuity screening tests should be done between three and four years of age in all children. In general linear visual acuity tests are very effective in picking up amblyopia with a specificity well above 97% and a sensitivity of 95%. This means that 95% of children with amblyopia are correctly identified using this screening technique. It is thought that amblyopia is uncorrectable after about six or seven years of age, so as long as they are diagnosed before this time the prognosis for normal vision is excellent.

Reference: Sjostrand J. and Abrahamsson M., Prevention of Amblyopia and The Concept of Cure. European Journal of Ophthalmology, 1997;7:121-129

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