What Causes Eyes to Be Misaligned?

Checking eye alignment is an essential component of an eye exam. Eye alignment issues include misaligned eyes, crossed eyes, and wall eyes. To understand eye alignment issues, you must begin by defining the term.

Strabismus

Strabismus, or crossed eyes, is a condition where a person’s eyes do not line up correctly and point in different directions. Essentially, one eye may look straight ahead while the other turns down, up, outward, or inward. 

Types of Strabismus

Eye care professionals categorize this eye condition by the direction of the misaligned or turned eye. The four categories are:

• Esotropia or inward turning.
• Exotropia or outward turning.
• Hypotropia or downward turning.
• Hypertropia or upward turning.

Muscles That Control Eye Movement

Six muscles work together to control eye movement under normal conditions. These muscles point both eyes in the same direction. One eye muscle moves the eye left, and another moves it right. The other four move the eye down, up, and at an angle. These muscles must work together to focus on a single image. 

What Causes Strabismus?

People with strabismus have problems with eye movement and normal ocular alignment. Both eyes must have balanced muscles that work together to focus both eyes on a single target. Some of the risk factors for eye misalignment include:

Genetic and Developmental Conditions

Some eye alignment issues, primarily inward-turned eyes, may result from a genetic variant. Certain developmental conditions, such as Down’s syndrome and cerebral palsy, may also cause eye misalignment. 

Premature Birth

Infants born prematurely have a significantly higher risk of an inward eye turn. Children who undergo oxygen treatment at birth may be at a higher risk for retinopathy of prematurity. That causes blood vessels at the back of the eye to develop irregularly.

The proper development of the nerve layer responsible for seeing, called the retina, depends on these blood vessels. Irregular growth of the retinal blood vessels may disrupt sensory stimuli. That may ultimately lead to abnormal visual development and subsequent eye misalignment. 

Trauma and Infection

Some infections like meningitis and herpes can negatively affect the eyes. They can disrupt the nerves that control eye muscles, leading to a temporary or permanent change in the eye’s position. 

A traumatic injury to the eye or around the eye can also affect the eye muscles that keep the eyes aligned. A difficult delivery can cause trauma to an infant’s head and orbital cavity surrounding the eye. 

High-impact sports and fighting can fracture the orbital bones, affecting the eye muscles and causing eye misalignment. The same applies to complications secondary to eye procedures and cosmetic surgery. 

High Eyeglass Prescription

Sometimes, a high eyeglass prescription can cause an eye turn. Kids with high hyperopia can have inward-turned eyes as their eyes’ focusing systems try to achieve visual clarity. In other cases, kids with significant refractive differences between their eyes may exhibit an eye turn. That is because they tend to use one eye more than the other, shutting off signals to and from the other. 

For more on eye misalignment, visit In Focus Vision Center at our Piscataway, New Jersey office. Call (732) 313-2570 to schedule an appointment today.