Eye misalignment, often called strabismus, occurs when the eyes do not point in the same direction. It can appear at any age and has a range of causes and clinical patterns. The information below gives general guidance on recognition, evaluation, and which specialists are typically involved; it does not replace personalized medical advice.
Eye misalignment means one eye looks in a different direction than the other. Patterns include inward turning (esotropia), outward turning (exotropia), vertical misalignment, and paralytic forms when a nerve affecting eye movement is involved. The difference can be constant or intermittent and may be associated with double vision (diplopia) or reduced visual development in children.
Signs include one eye that appears turned, head tilting to compensate, uneven eyelid position, or complaints of double vision. Sudden onset misalignment, especially with severe headache, sudden vision loss, weakness on one side of the body, confusion, or recent head trauma warrants prompt medical attention; in those cases emergency assessment is appropriate.
Evaluation usually begins with an ophthalmology (eye disease) exam that includes vision testing, assessment of eye alignment and movements, and orthoptic measurements. In children, pediatric ophthalmology, pediatrics, and orthoptists commonly participate. Adults with neurological signs may need neurology input; endocrine disorders or systemic conditions may prompt consultations with other specialties. Imaging (CT or MRI) is sometimes used when a neurological cause is suspected.
In children, common contributors are congenital factors, uncorrected refractive errors, or developmental issues affecting binocular vision. In adults, causes can include cranial nerve palsies, thyroid eye disease, trauma, or new-onset muscle imbalance. Because causes and risks differ by age, specialist assessment helps determine the likely origin and the appropriate diagnostic path.
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