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Strabismus: Non-Surgical Treatment

The formal term used when the eyes are out of alignment is “strabismus.”  There are many types of strabismus; esotropia (eyes turned inward), exotropia (eyes turned outward), hypertropia (an eye is turned upward) and many more.  The misalignment can be constant or intermittent.  It can involve one or both eyes.

In about one-half of those who have strabismus, also have “amblyopia.”  Amblyopia is referred to by some as “lazy eye.”  Yet, it really isn’t that the eye isn’t trying to see, it just hasn’t developed the ability to see; it hasn’t yet learned to see.

Glasses alone can occasionally treat certain types of strabismus.  More often than not, Optometric Vision Therapy is required to more completely teach the brain how to keep the eyes aligned.  As a last resort, surgery is sometimes required.  If surgery is required, pre-surgical vision therapy usually makes the surgical outcome much more successful.

Patching with an opaque sticky patch over one eye, or a “pirate patch” over a child’s glasses used to be the fate for young children with amblyopia.  This is very challenging for parents to enforce and socially very difficult for most children. It also interferes with the ability participate in the athletic and academic environments at school.  Fortunately, these methods are no longer necessary for a successful therapeutic outcome.

With the use of special “graded translucent occluders” (Bangerter), there is very little cosmetic concern, and it provides for the brain to appreciate simultaneous input from each eye, input crucial for developing and maintaining eye-alignment.  In addition to these “graded translucent occluders,” Optometric Vision Therapy (sometimes called orthoptics and pleoptics) is used to actually teach the brain to use the eye to see, and align with the other eye.


An amblyopia evaluation can be performed on infants, toddlers as well as brain injured patients who cannot speak.  In addition to evaluating for strabismus and amblyopia, the examination evaluates eye health, visual acuity, visual tracking, depth perception, eye coordination, and the presence of nearsightedness, farsightedness and astigmatism.  These evaluations are not brief, and usually require up to an hour of assessment.

In infancy, an eye that occasionally drifts out of alignment is not normal.  Your child may not “grow out of it”.  It is not worth the risk to wait and see if it will go away.

Amblyopia “Lazy eye”

Amblyopia occurs in 1 in 25 to 30 infants.  This is a loss of vision to one eye, and cannot be detected by observant parents. Unfortunately, these children suffer a loss of depth perception that interferes with a wide variety of life experiences.  Fortunately, this is treatable.  Success has been shown even into adulthood! 


Strabismus (eyes out of alignment) occurs in 1 out of 30 to 35 children.  Strabismus is often evident to the parent, and is often thought that the child will “grow out of it.”  Unfortunately, this is rarely the case.  Since vision therapy is frequently successful in treating strabismus, surgery has become a last resort option.

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