If Your Dog’s Eyes Are Crossed — Causes of Strabismus and When to Seek Treatment

Strabismus, commonly known as cross-eyedness in dogs, is an eye condition where the eyes do not align properly. It can be caused by genetic factors or nerve damage. Early detection and proper management are crucial for preserving your dog's vision.

Strabismus in Dogs Is an Ophthalmic Condition Where the Eyes Are Misaligned

Strabismus in dogs refers to a condition where the eye is misaligned within the orbit, deviating from its normal position. Rather than being an independent ophthalmic disease, it is often a sign of underlying neurological or orbital disorders. It is important to distinguish strabismus from proptosis, where the eye bulges out of the orbit, or buphthalmos, where the eye enlarges. - Neurological disorders: Strabismus is frequently associated with vestibular abnormalities, intracranial (brain) diseases, or damage to cranial nerves, particularly the oculomotor and trochlear nerves. - Orbital diseases: Conditions that push the eye outward, such as orbital inflammation (cellulitis) or tumors, can cause strabismus alongside proptosis. - Breed and systemic disease predispositions: Strabismus has been reported in certain breeds and systemic conditions. If there is a family history, early monitoring from a young age is recommended. Professional evaluation by a veterinarian is essential for accurate diagnosis and vision protection.

The Main Causes of Strabismus Are Genetics, Nerve Damage, and Muscle Abnormalities

While the causes of strabismus are varied, most stem from issues with the nervous system or the orbit rather than the eye itself. - Nervous system damage: Vestibular disorders, intracranial diseases, or cranial nerve paralysis can cause strabismus. Damage to the oculomotor nerve (CN III) causes the eyeball to deviate dorsally and laterally, while damage to the trochlear nerve (CN IV) results in rotational strabismus. - Orbital diseases: Inflammation or tumors in the orbit can push the eyeball outward, leading to strabismus accompanied by exophthalmos. - Breed and systemic disease predispositions: Veterinary literature reports cases of strabismus in some mixed-breed Beagles and Huskies, as well as visual abnormalities associated with systemic diseases like mucopolysaccharidosis in breeds such as Shiba Inus. To determine the exact cause, veterinarians conduct comprehensive neurological and ophthalmic examinations.

The Main Symptoms of Strabismus Are Eye Misalignment and Vision Problems

The most noticeable sign of strabismus in dogs is a misalignment of the eyes. The eyeball may deviate dorsally or laterally (due to oculomotor nerve paralysis), rotate (due to trochlear nerve paralysis), or point downward. - Accompanied by nystagmus: Strabismus often occurs alongside nystagmus, a rhythmic shaking of the eyes. - Head tilting: If vestibular dysfunction is present, the dog may tilt its head to one side to maintain balance. - Balance and gait abnormalities: Vestibular symptoms such as circling or leaning to one side may also be observed. - Decreased vision: Some dogs may show reduced visual responsiveness. Because these signs can indicate neurological disease, early evaluation is important.

Diagnosing Strabismus Involves Ophthalmic Examination and Imaging

Diagnosing strabismus involves not only an ophthalmic examination but also a neurological assessment. - Neurological and cranial nerve examination: We evaluate pupillary reflexes, eye movements, and the presence of resting or positional strabismus and nystagmus to determine the location of the lesion. - Imaging studies (CT and MRI): Advanced imaging such as MRI and CT provides the most accurate information for identifying lesions in the orbit, tissues behind the eye, and within the skull. - Ophthalmic examination: We assess ocular structures and visual responses to determine the impact on vision. - Comprehensive health evaluation: Since strabismus can be a symptom of systemic disease, we also evaluate the overall health status. A professional assessment by a veterinarian is essential for an accurate diagnosis.

Treatment Methods Vary Depending on the Cause, and Surgery May Be Required

The key to treating strabismus is identifying and addressing the underlying cause. - Neurological causes: If the strabismus is caused by vestibular disease, intracranial conditions, or cranial nerve damage, the priority is to diagnose and treat the underlying condition. - Orbital disease causes: If inflammation or tumors in the orbit are the cause, treatment for those specific conditions is necessary. - Cause-specific approach: The treatment direction varies significantly depending on the cause and severity, so the veterinarian will develop a plan based on the examination results. - Re-evaluation and management: During treatment, neurological symptoms and changes in vision are regularly re-evaluated to monitor progress. The outcome depends on the type of underlying disease and whether it was diagnosed early.

In Home Care, It Is Important to Minimize Stimuli and Maintain a Stable Environment

For dogs with strabismus, the key to home care is maintaining a stable environment. - Minimize stimuli: Avoid sudden noises, bright lights, and interactions with other animals that could lead to conflict. - Secure the play area: Remove sharp objects and eliminate hazards that could cause falls from heights. - Manage activity levels: Since balance may be impaired, be cautious with activities involving excessive running or rolling around. - Medication administration: Give prescribed medications at the correct times and in the exact dosages. - Regular check-ups: Communicate regularly with your veterinarian to monitor recovery and progress. A stable environment greatly aids in healing.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

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