Strabismus, or misalignment of the eyes in any gaze direction, is one of the most common eye problems in childhood. Early diagnosis and appropriate treatment are essential because strabismus is not just an aesthetic issue—it can also lead to serious complications such as amblyopia (lazy eye).
In the newborn period, temporary outward drifting of the eyes may be observed because the retina and neural pathways are not fully developed. This usually resolves by 2–3 months of age. However, if eye movements remain uncoordinated after the third month, evaluation by an eye specialist is necessary.
Another common situation for parents is pseudo-strabismus. This occurs when the eyes appear to turn inward due to a flat nasal bridge or eyelid structure. To distinguish it from true strabismus, diagnostic methods such as the cover test are used.
Strabismus that appears within the first year of life is referred to as infantile strabismus. The most common form is infantile esotropia (inward turning). If the deviation is stable and significant hyperopia is absent, surgical correction is recommended to align the eyes. Studies show that surgeries performed within the first 18 months are more successful in developing stereopsis (depth perception).
In children aged 1–3 years, inward deviations are usually related to refractive errors. In these cases, a cycloplegic eye examination should be performed, and the resulting hyperopia should be fully corrected with glasses. If the deviation persists despite glasses, surgical intervention may be considered.
A less common but important type of strabismus in children is intermittent exotropia (outward turning). This is often more noticeable when a child is tired, feverish, or in bright sunlight. If the deviation becomes frequent and threatens binocular vision, a treatment plan should be implemented.