When do crossed eyes in a baby need an eye exam?

What does the evidence show for strabismus in babies?

• The AAP advises discussing regular inward crossing or outward drifting after four months with the child’s doctor. By about three months, difficulty making steady eye contact or following a moving object also warrants attention. Do not rely only on whether the baby seems comfortable. 1
• Misalignment can be constant or intermittent. The brain may suppress the image from one eye, leading to amblyopia, sometimes called lazy eye. Strabismus and amblyopia are connected but are not interchangeable names for exactly the same problem. 2
• An eye examination assesses alignment, visual function and eye health. Glasses, prescribed patching for amblyopia or eye-muscle surgery may have different roles depending on the findings. A patch should not be selected or placed on an eye without the specialist’s directions. 2
• A white or gray pupil, rapid fluttering eye movements, persistent redness, drooping eyelid or apparent visual difficulty should also be reported. A photo or short video can help describe an intermittent observation, but an image cannot replace the examination. 1
• Prematurity, low birth weight and a family history of childhood eye conditions can increase the risk of amblyopia. Share that history with the eye team; limited outward symptoms do not reliably describe how well each eye sees. 3
• Infant vision checks examine the pupils, reflected light and eye structures before a child can read an eye chart. Follow through on an eye referral even when the baby seems to recognize faces normally. 4

When should I call my provider about strabismus in babies?

Arrange prompt assessment for persistent or newly concerning eye misalignment, a white or gray pupil, apparent loss of vision or unusual rapid eye movements. Seek urgent care when an eye problem follows an injury or the baby also appears seriously ill. Do not postpone evaluation simply because crossing is intermittent.