Cross-Eyed Baby: Rarely Cause for Concern and What to Do

Cross-Eyed Baby: Rarely Cause for Concern and What to Do

There is nothing cuter than a newborn baby. If you have recently brought home a new addition to the family, you have undoubtedly already spent countless hours admiring their adorable face. During that time, you may have noticed that your infant’s eyes appear crossed. The first thing to know about crossed eyes in babies is that this is quite common, and almost always nothing to worry about.

The medical term for when eyes become misaligned is strabismus, and it is something that about 1 in 20 newborns will experience. In some cases, it will be barely noticeable. In others, the eyes can be looking in opposite directions. This issue may only impact one eye, or both could wander.

Regardless of how significant the strabismus is for your child, you will want to learn everything you can about this condition, and how to best address it. Note that, even when a baby does not grow out of this issue (which is rare), it is almost always treatable and will not cause long term problems for your little one.

What to Do if Your Baby Experiences Strabismus

The first thing to do if you notice that your newborn’s eyes are crossing is mention it to the other parent or another caregiver for your little one. This is especially important if the misalignment is not extreme. Once everyone who spends a significant of time with your child is aware of your concerns, you will want to start keeping track of as many details about it as possible.

In the event that you do need to see an ophthalmologist, they will be able to make a better diagnosis if they have more information about the symptoms. Some key pieces of information to write down when you notice your infant’s eyes crossing include:

  • Time of Day – When is it occurring (Especially in relation to their sleep schedule)?
  • Which Eye – Does one eye always wonder, or is it both?
  • Direction of Eye – Where do the eyes look when misaligned?
  • Frequency – Do their eyes always cross, or only sometimes?

When to Contact the Doctor

If your baby’s eyes are still crossing after four months, it’s good to think about consulting your doctor. Most newborns will be visiting their doctor multiple times over the course of the first year, so you can usually just let them know on a regularly scheduled visit. While most babies who have crossed eyes will end up growing out of it without any intervention, it is a good idea to keep their pediatrician informed so they can offer guidance.

If the next doctor visit is not going to take place for a month or more, or you notice that your little one’s eyes are crossing more, give the doctor’s office a call. They can let you know whether you should bring your baby in right away, or if it is best to just wait for the next appointment. Of course, if the situation is causing you anxiety, it is always fine to set up an appointment just to set your mind at ease.

Different Types of Crossed-Eyes

Ophthalmologists have different names for different types of strabismus depending on the symptoms that are presented. When treatment is necessary, the specific steps taken will often depend on how severe the misalignment is and exactly how the eyes are behaving.


This is when one or both eyes turn in toward the nose. It is the most common type of strabismus. Approximately 3% of children will experience it at some point, with the first few months after birth being the most common time.


This is when one or both eyes turn away from the nose, toward the outside of their face. Just over 1% of kids will experience this issue.


With hypertropia, your child’s eyes are misaligned vertically. One eye will be looking further up than the other. Vertically misaligned eyes are much less common than horizontal issues and will only impact about 1 out of every 400 children (whether hypertropia or hypotropia).


Hypotropia is the opposite of hypertropia and is when the impacted eye points down lower than the other one.

Causes of Crossed or Misaligned Eyes

There are quite a few things that can cause your newborn to have crossed or misaligned eyes. Sometimes you will be able to determine the exact cause of the issue yourself. Other times, a doctor will need to perform some tests to identify exactly what the cause of the issue may be.

Normal Development

In most cases, cross-eyed babies are just going through normal development. Their eyes and brain are constantly learning how to perform all normal activities, including controlling their eyes. Most newborns who experience crossed eyes will grow out of it by the time they are four months old.

Muscle Weakness

The eye is controlled by muscles attached to the back of the eye. If the muscles are weak on one of the eyes, it may not be able to precisely control the eye to get it to align perfectly with the other one. In most cases, the muscles will strengthen over time. In some situations, the brain will simply stop attempting to use the weaker eye, which can cause the problem to get worse. In these cases, treatment will be necessary.


Just like adults, newborns sometimes do not fall right asleep when they are tired. In addition, sometimes their brain stops processing signals from the eyes before they are closed. This often looks like crossed eyes, but it is actually just the relaxed state of the eyes that is normal when sleeping.


If you have a history of strabismus in your family, your baby is more likely to experience this problem. Families with this issue will want to pay especially close attention to their newborn’s eyes and seek medical attention sooner than other people. When treated early, it can often be easier to resolve crossed eyes.


Trauma to the eye can cause them to become crossed. This trauma can include surgery, head injuries, or even just getting a direct bump on the eye. In most cases, strabismus caused by trauma will resolve itself as the eye heals naturally.

Neurological Issues

There are some neurological issues that can cause your baby to have trouble aligning their eyes. This could be caused by issues with the nerves in the eye sending signals to the brain, trouble with the brain processing them, or other rare conditions.
Small baby with strabismus

Treatments for Crossed Eyes

The most common treatment for crossed eyes in infants is actually no treatment at all. Since newborns will typically grow out of this naturally as they develop, doctors will normally just take a wait and see approach until your little one is 3-4 months old. If the issue does not resolve itself, or it gets worse, there are several different treatment options that are available.

When treatment is needed, your family doctor will almost certainly refer you to an ophthalmologist to plan and administer the treatment options, which may include one or more of the following.

Eye Patch

When a baby has crossed eyes because one of their eyes is weaker than the other, the most common treatment is to ‘exercise’ the weak eye to help it to develop. The first way to attempt to do this is to place an eye patch over the good eye of your little one, which forces them to exclusively use the weaker eye.

Your ophthalmologist will give you instructions for how often your baby should wear the eye patch, and for how long each time. Since infants are developing rapidly at this stage of life, this type of therapy can get great results surprisingly quickly.

Eye Drops

Eye drops are an alternative option to an eye patch if you have a little one who constantly tries to remove the patch. These eye drops will blur the vision of the good eye, which forces the weaker eye to be relied upon and strengthened.


In more severe cases, or in situations where the eye patch or drops did not work, surgery may be an option. A surgeon will carefully go in and tighten or loosen the muscles behind the eye. This will allow your baby’s eyes to align properly. Surgery is a much more common option when eyes are always crossed rather than for those whose eyes only cross occasionally.


Some ophthalmologists are injecting small amounts of Botox into the muscles of the eye. This may be considered either as an alternative to surgery, or an option when surgery was ineffective. The Botox will paralyze the muscles slightly, which can help improve alignment.

Long-Term Outlook for Your Baby

In the end, you can rest comfortably knowing that the odds are strongly in favor of your baby having normal vision and eyes that do not cross as they get older. Even if your little one’s eyes do not correct themselves on their own, the treatment options available today are highly effective.

Finally, even if your newborn is one of the exceptionally rare cases where the treatments do not address the crossed eyes, they will likely be able to get relief using glasses or contacts. For now, make sure to watch your little one’s eyes closely, and work with your doctor to ensure they get any treatment that is needed.