Strabismus, more commonly known as “cross-eyed” or “wall-eyed” is a vision condition in which the eyes do not properly align with each other. One or both eyes may turn in, out, up or down. It can be constant, or intermittent, such as in stressful situations, when tired, or ill. I have lived with strabismus for over forty-five years. The purpose of this article is not to provide information about the condition of strabismus, but to give you some insight into how it affects a person who has lived with it, to help you see through my eyes.
My mother first noticed that from time to time, my eyes did not seem to be aligned. One eye would turn out to the side, while one remained straight. The affected eye, in my case, would alternate, but tended to happen most often in my left eye. The eye would turn outward at sixty degrees, which was all the way over to the corner of my eye. My mother was alarmed, and took me to our family doctor who recommended an ophthalmologist.
The eye doctor we saw examined my eyes and suggested a couple of things to try. Since my left eye was the one most commonly affected, he suggested that my mother patch the right eye several hours each day, so that I would “be forced to use my bad eye.” (I never lost vision or had diminished vision in that eye, so it was not really any weaker visually than the other.) He also suggested exercises that my mom and dad could do at home. The exercises involved my sitting on the floor in front of them while they took a pencil with the eraser end about a foot and a half from my nose, and then moved the pencil from side to side, up and down, or in slow circles, while I concentrated on keeping both eyes on the pencil. This was to be done for ten minutes or so several times a day. He also gave me a stern warning that if I did not “hold them straight” they might stick in a crossed position, and this really frightened me. I don’t know to this day if that is true or not, but it caused me a lot of anxiety.
The doctor said that surgery was not an option (Remember: This was the late 1950’s; things have changed) because it affected both eyes and not just one. My parents tried the patch and the exercises and neither helped. The patch was very embarrassing to me. I refused to go outside to play wearing it, so spent much more time inside than I would have normally. My sister made fun of me, which caused me to be even more self-conscious.
I could hold my eyes straight if I concentrated on it. I try to explain what it is like to someone who has never had strabismus like this. If I asked you to hold your arm out parallel to the ground, you can do it. However, if I asked you to hold it like that, you could until you became tired or distracted with something else and then your arm will naturally drop down. That is how it feels to try to hold eye muscles in alignment. I had eye strain and occasionally had headaches.
I was so fearful of being ridiculed for my eyes, that I learned some behaviors early on to avoid this. I rarely looked people in the face when I talked to them, and if I did, only a brief glance before looking down. I avoided speaking in front of a group, or sitting at a table facing others. I sat on the front row in school so that if my eye wandered no one would notice. It was easier to hold it straight when the teacher looked my way than to try to hold it straight all the time. In addition, since when I became tired, it became harder for me to focus my eyes even when they were straight, I usually closed one eye to read the chalkboard.
I usually had one close friend, rather than being very outgoing. Occasionally someone would ask what the matter with my eyes was, and I would immediately straighten them and say, “Nothing!”
I am sure throughout my life more people noticed than I cared to think about, but I can remember only ten or fifteen times that anyone said anything rude about it. I did have a boyfriend in high school who said, “Your eyes are just all over the place!” I broke up with him and never told him why.
I did well in my school subjects, but avoided most sports. I could not catch a ball, because it was too hard to follow it coming at me. It was also much more difficult for me to judge distances. I learned to judge distance by size of things rather than by trying to fuse the image. I liked archery, bowling, or any other sport in which I did not have to face anyone to play.
Socially, I avoided group settings. I tended to isolate and preferred being alone or with one or two close friends than to go to parties or other gatherings. I avoided any situation in which I would be required to do public speaking. All of these coping mechanisms became unconscious acts to me. I did not spend much time thinking about how to avoid others noticing my eyes, but tended to withdraw from situations that made me uncomfortable.
Being fitted for eyeglasses gave me as much anxiety as some people experience at the dentist. During the exam when I was asked to look into the eye scope and tell which color sign was closer or farther away, or which was above or below the other, I was lost. I would say they both looked the same to me. One eye doctor got so frustrated with me, he yelled at me. One just stormed out of the room. However, I was just trying to tell them how things looked to me. When I was twenty, I found an eye doctor that added prisms to my glasses, and for the first time, my eyes stayed straighter with less strain and effort. What I did not know was that over time I would require stronger and stronger prisms to do the same thing.
When I was fifty, I saw an ophthalmologist for another condition, and she asked about the strabismus. She said I should have the surgery to correct it. Honestly, this was the first time surgery was ever suggested as an option for me. She referred me to a strabismus specialist at Callahan Eye Foundation in Birmingham, Alabama. His name is Dr. Martin Cogen. He completed my surgery on November 10, 2006. I have gone from a sixty-degree turn out to a four degree, which so far I am easily able to control. Because at the time I am writing this, it has been only three weeks since the surgery, he feels the final results are not yet known, and I may end up with eyes perfectly aligned once the healing is over. Even at this stage, I am well pleased.
I am not sure how the surgery will affect me socially yet. The coping mechanisms I have come to use have been conditioned in me over fifty years, and I am sure it will take some effort to change them, but I am willing to try. I would recommend if you or your child has strabismus that you talk to someone about all your options. Uncorrected strabismus affects more than vision. It can correct your emotional and social development as well.
