Written on the day I turned 46 by Dr Muhammad Azeem— with help from ChatGPT, but the thoughts and ideas are entirely mine.
It’s not uncommon for parents to notice that their child seems to be looking in a slightly different direction — one eye straight, the other drifting outward or inward. The first reaction is usually worry, and often, parents try to recall a cause: “This started after that high fever,” or “Maybe it’s because of too much screen time.”
But before jumping to conclusions, here’s the most important thing to know: the first test that should be done is a cycloplegic refraction along with a fundus examination.
These two tests help determine whether the misdirection (or tropia, in medical terms) is due to a need for glasses, an eye muscle imbalance, or something more serious.
Common Causes and Misconceptions
Most cases of strabismus (eye misalignment) begin to appear when a child is around 2½ to 3 years old. That’s the typical age when the condition becomes noticeable. Parents often associate its onset with a specific event — like an illness or fever — but in reality, it’s usually unrelated.
There are, however, two exceptions:
Infantile tropia, which appears in babies very early in life.
Tropias caused by organic diseases such as cataracts or eye tumors, which can also show up earlier and require urgent medical attention.
Treatment Options Differ
Not every deviation requires surgery.
Some children only need glasses to correct the underlying issue.
Some may need eye muscle surgery to realign the eyes.
And in some cases, the best approach is simply careful observation over time.
The key is a proper and detailed eye examination by a specialist — not guessing, not panicking.
What Parents Can Do
If you notice your child’s eyes seem misdirected:
Get a complete evaluation — cycloplegic refraction and fundus examination are the first steps.
Stay calm. Most causes are treatable.
Encourage daytime outdoor activities.
Outdoor play helps overall eye health.
It also naturally limits screen time, which is good for every child’s visual development.
Takeaway
Don’t panic. Don’t delay.
If your child’s eyes appear misaligned, get them checked properly and follow your doctor’s advice. With timely diagnosis and care, most children do very well — and get back to focusing straight ahead.
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