Posted by: Eye Health Northwest in General Eye Health on March 16, 2026
Imagine glancing at your computer screen and seeing a second line of text floating above the one you were reading. Or picture yourself driving down the highway when a car appears to drift into your lane, only for you to realize the problem is with your eyes, not the road. These unsettling moments are often the first sign of adult strabismus, a condition where the eyes fall out of alignment and point in different directions.
About 4 percent of adults in the United States experience strabismus at some point in their lives, according to the American Academy of Ophthalmology. The good news is that this condition is very treatable. Keep reading to learn what causes it, how to recognize the symptoms, and what your options are for getting your eyes back on track.
What is Adult Strabismus?
Six tiny muscles surround each eye and work together to control movement. When those muscles are balanced, both eyes focus on the same spot simultaneously.
Your brain then blends those two images into a single, three-dimensional picture. That process is what gives you depth perception and a clear sense of distance.
With strabismus, one eye may turn inward, outward, upward, or downward while the other looks straight ahead. Because both eyes are sending different images to the brain, adults with this condition typically experience double vision.
Unlike children, whose brains can learn to suppress images from the misaligned eye, adult brains have already been trained to receive input from both eyes and cannot simply ignore one.
What Causes Strabismus in Adults?
Many adults who develop strabismus actually had it as children. In some cases, the condition resolves during childhood but recurs later in life.
As you get older, eye muscles naturally weaken, and alignment that once held steady can begin to slip. Ophthalmologists refer to this gradual change as decompensation.
Health conditions that affect blood flow or nerve function are another common trigger. Diabetes, high blood pressure, and mini-strokes can all reduce circulation to the eye muscles or the nerves that control them.
Thyroid eye disease (sometimes called Graves’ eye disease) can also lead to misalignment, even when thyroid levels are well managed with medication. Neurological issues can also lead to strabismus.
Damage to the cranial nerves that direct eye movement, whether from a brain tumor, head trauma, or stroke, can disrupt the signals that keep both eyes working in sync. Previous eye surgery may also affect the surrounding muscles, contributing to misalignment over time.
How is Adult Strabismus Treated?
Treatment depends on the type and severity of the misalignment. For mild cases, your ophthalmologist may prescribe prism lenses, which are special wedge-shaped lenses built into your glasses. These prisms bend light so the brain can merge the two images into one, reducing or eliminating double vision.
When prisms are not enough, surgery is the most widely used approach. The procedure is typically performed on an outpatient basis with local or general anesthesia.
Your eye surgeon repositions the eye muscles so both eyes can aim at the same point again. Some surgeons use adjustable sutures, which allow fine-tuning after the procedure.
Other options include targeted eye muscle exercises for patients whose eyes struggle to align during close-up tasks like reading, and botulinum toxin injections that temporarily relax overactive muscles. Your eye doctor will recommend the approach that best fits your specific situation.
Schedule Your Eye Exam Today
If you are experiencing double vision or eye misalignment, schedule a comprehensive eye exam at EyeHealth Northwest in Portland, OR, today. Our experienced team can identify the cause of your strabismus and create a personalized treatment plan to help you see comfortably again.
