Why Newborns Appear Cross-Eyed

It's normal for a newborn to appear cross-eyed for the first few months of life. This is typically due to under-developed eye coordination and usually goes away by 4 months of age.

Crossed eyes in babies older than 4 months, however, may indicate an eye condition known as strabismus. This occurs when the eye muscles don't coordinate eye movements correctly. If caught early, it may be corrected with glasses or therapy, although sometimes surgery is needed.

This article explains why most newborns have crossed eyes from time to time. It also explains when to talk to your pediatrician about your newborn's vision and how crossed eyes are treated.

Newborns and Crossed Eyes

There are several reasons the appearance of crossed eyes occurs with new babies. One is that sometimes babies are born with extra skin folds in the inner corners of their eyes, giving them the appearance of crossed eyes. However, as these babies grow, these folds start to disappear.

Another reason a newborn infant's eyes appear crossed from time to time is due to a lack of development at this stage. Therefore, it is common for a newborn's eyes to move independently of each other.

The cross-eyed look sometimes causes concern for new parents. However, by the age of 3 or 4 months, an infant's eyes should be straight and able to focus on objects without turning outward or inward.

Older Babies and Crossed Eyes

Strabismus is an eye misalignment resulting from a failure of the eye muscles to work together. If your baby is older than 4 months and still has the appearance of crossed eyes, you might suspect strabismus.

Symptoms to watch for include:

• Eyes that continue to cross
• Eyes that move inward or outward
• Eyes that don't appear to focus together

Early detection of strabismus or other eye disorders is vital for preserving a child's future vision. An eye doctor can perform several tests on babies and young children to determine if treatment is needed.

If your child has strabismus and does not receive proper treatment, their brain could start to ignore the messages sent from one of their eyes. Over time, the neglected eye may become lazy and result in vision loss if left untreated.

This visual condition is known as amblyopia or "lazy eye." In addition to developing amblyopia, depth perception could also be affected.

Causes

Strabismus sometimes runs in families. But it can also show up in children with no family history. When genetics don't play a role, it's more likely a doctor will diagnose a significant vision problem.

Some children are more at risk of developing strabismus, including:

• Those with cerebral palsy 
• Those with Down syndrome 
• Premature babies
• Low birth weight babies
• Children with farsighted vision

Treatment

Doctors can often correct strabismus with glasses. This treatment is usually successful if caught early in a child's life.

However, sometimes wearing glasses is not enough to correct strabismus, and treatment may include surgical correction. Eye doctors will operate on the eye muscles, maneuvering them to pull the eyes into the correct position.

Summary

Crossed eyes during the newborn stage are quite common. However, if a baby older than 3 or 4 months has crossed eyes, they may have an eye condition called strabismus. This condition requires treatment, or it could lead to lazy eye and vision loss. Glasses often correct the situation, but it sometimes requires surgery.

A Word From Verywell

If a newborn appears crossed-eyed, it's important to get an evaluation as soon as possible. Getting a diagnosis and treatment, particularly before they reach seven to eight years of age, is essential to reduce the risk of lazy eye.

— ANDREW GREENBERG, MD, MEDICAL EXPERT BOARD