Understanding Misalignment
Strabismus (often called crossed eyes or a wandering eye) is a condition in which the eyes do not properly align with each other when looking at an object. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward.
This misalignment prevents the brain from fusing the two separate images from each eye into a single, 3D picture, often resulting in double vision (diplopia) or the loss of depth perception.
Childhood Onset
Often developmental or refractive.
Adult Onset
Often sudden, requiring urgent medical evaluation.
When Does it Happen?
Strabismus in Children
In children, strabismus usually develops before the age of 3. It is often the result of poor eye muscle control, high amounts of uncorrected farsightedness, or family genetics.
Children rarely complain of double vision because their highly adaptable brains simply "turn off" or suppress the image from the turned eye. However, if left untreated, this suppression leads to Amblyopia (Lazy Eye), causing permanent vision loss in the misaligned eye.
Early detection is vital. Dr. Fouladian often treats pediatric strabismus by prescribing specialized eyeglasses to relax the eye muscles, allowing the eyes to straighten naturally.
Adult-Onset Strabismus Medical Warning
When an adult suddenly develops an eye turn, they almost always experience sudden and severe double vision. Adult brains cannot easily suppress the second image.
A sudden onset of misaligned eyes in an adult is a major red flag and must be evaluated immediately.
In older patients, the eye muscles themselves are rarely the problem. The issue typically lies in the nerves or blood vessels supplying those muscles.
Systemic Causes in Older Patients
Vascular Events
A stroke or microvascular damage caused by uncontrolled high blood pressure or diabetes can paralyze the cranial nerves that control eye movement.
Neurological Issues
Brain tumors, aneurysms, or neurological conditions like Myasthenia Gravis or Multiple Sclerosis can interfere with the brain's ability to coordinate the eyes.
Head Trauma
A severe head injury, concussion, or orbital fracture can directly damage the eye muscles or the nerves controlling them.
Treatment & Management
Dr. Fouladian's Approach
We focus on resolving the double vision and treating the underlying cause.
Specialized Prism Lenses
To eliminate double vision, Dr. Fouladian frequently prescribes specialized eyeglasses containing Prism. A prism is a wedge-shaped lens that bends light before it enters the eye. By bending the light to match the exact angle of the misaligned eye, the brain can fuse the images back together, instantly curing the double vision.
Refractive Tailoring
In some cases, over-focusing (accommodation) triggers the eye to cross. Dr. Fouladian meticulously adjusts the refractive prescription (adding plus power or utilizing bifocals) to force the eye muscles to relax and straighten.
Neuro-Ophthalmology Co-Management
Because sudden-onset strabismus can be a symptom of a life-threatening systemic issue, proper medical triaging is crucial.
Dr. Fouladian works collaboratively with some of the most esteemed Neuro-Ophthalmologists and Neurologists in the Los Angeles area. If your strabismus is deemed complex, requires an MRI/CT scan, or necessitates eye muscle surgery, we will immediately fast-track your referral and co-manage your care with these top specialists.
When to See Dr. Fouladian
If you or your child develop an eye turn, or if you suddenly experience double vision, do not wait.
Contact our office immediately for an urgent medical evaluation.
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