Overview
Babies' eyes may wander occasionally in the first few months. After about 4 months, eyes should line up. If one eye turns in, out, up, or down, it should be checked.
In children, untreated strabismus can cause amblyopia (lazy eye), where the brain ignores one eye. Early treatment works best. In adults, new misalignment and double vision can come from nerve problems, stroke, thyroid eye disease, diabetes, or, rarely, a tumor or aneurysm.
When to get medical care
Causes
In children, causes include problems with the eye muscles, farsightedness (accommodative esotropia), family history, premature birth, and conditions like cerebral palsy or Down syndrome. In adults, causes include cranial nerve palsy (from diabetes, high blood pressure, stroke, or aneurysm), thyroid eye disease, myasthenia gravis, head injury, and past eye surgery.
OwieClear has pages on 5 conditions that can cause eyes that cross, wander, or don't line up. Each shows how soon to get care.
Common causes
- Lazy eye or crossed eyes (amblyopia or strabismus)See a doctor if it doesn't get better
Eyes that don't line up, cross, or wander, or one eye that sees less clearly.
- Eye movement nerve palsy (3rd, 4th, or 6th nerve)May need emergency care
Weakness of a nerve that moves the eye, causing sudden double vision.
Less likely causes
- Atypical teratoid/rhabdoid tumor (AT/RT)Often needs care today
A very rare, fast-growing brain tumor that mostly affects babies and children under 3.
- Eye cancer in a child (retinoblastoma) (needs checking)Often needs care today
A rare eye cancer in young children.
- MedulloblastomaOften needs care today
A fast-growing brain tumor that starts in the cerebellum, the part of the brain that controls balance.
What you can do at home
- Get an eye exam early for a child with a turning eye; don't wait for them to outgrow it.
- Use glasses or patches as prescribed, every day.
- Keep follow-up visits.
- Cover one eye to ease double vision until you're seen, if you're an adult.
Medicines
Treatment may include glasses, patching or eye drops for lazy eye, eye exercises, and eye muscle surgery. Adults may use prism glasses. Underlying causes are treated.
At the doctor
An eye doctor will check how your eyes line up and work together.
Questions you may be asked
- When the turning started
- Whether it's constant or comes and goes
- Double vision
- Family history
- Head injury, diabetes, or thyroid disease
The exam
An eye exam, including vision, eye alignment, and eye movements.
Tests
- A dilated eye exam
- Brain imaging for new adult cases
- Thyroid or other blood tests
Prevention
Early checks protect vision.
- Get children's eyes checked
- Use glasses and patches as directed
- Control diabetes and blood pressure
Check your symptoms
Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.
Sources
Last updated 2026-11-13.