New parents spend a lot of time staring into their baby’s eyes, so it can feel alarming if those eyes occasionally appear crossed or misaligned. Fortunately, crossed eyes in newborns are often completely normal during the first few months of life as babies learn to focus and coordinate their eye movements.
Still, there are times when crossed eyes may signal a vision or muscle issue that deserves medical attention. Understanding what’s normal, when babies typically outgrow crossed eyes, and what symptoms to watch for can help ease some of the worry.
If you’ve noticed your baby’s eyes crossing, drifting, or appearing uneven, here’s what parents should know.
In many cases, occasional eye crossing in young infants improves naturally as their vision and eye muscles continue developing.
Key Takeaways
- It’s common for newborns’ eyes to occasionally appear crossed during the first few months of life.
- Most babies’ eye alignment improves by 4 to 6 months of age.
- Persistent crossed eyes may be a sign of strabismus or another vision concern.
- Early evaluation and treatment offer the best outcomes for vision development.
Is My Baby Cross-Eyed?
Babies can sometimes appear cross-eyed even when they are not. If their nose has a wide nasal bridge, this can give the illusion that one eye turns in more than the other. They can also seem cross-eyed if they have an extra fold of skin on the inner eyelid. This extra fold can cover more of the white of the eye, making it appear like your baby has asymmetrical eyes.1
If it is not the skin or the nose causing your baby to appear cross-eyed, your baby’s eyes may be misaligned or pointing in different directions. Your baby’s eyes may cross only occasionally, or they may always appear crossed. One or both eyes can point in, out, up, or down instead of straight ahead and parallel.2
There are two common causes of what parents describe as “crossed eyes.” The first is when the eyes are actually crossed, which is caused by a problem with the muscles that move the eyes. The second is more commonly known as a “lazy eye.” A lazy eye can result from untreated crossed eyes. It can also happen when vision is poorer in one eye, so the brain uses only that eye, and the other eye becomes “lazy.”3,16
Is It Normal for My Baby To Be Cross-Eyed?
It’s normal for the eyes of very young babies to cross occasionally. Their eyes and eye muscles are still learning how to work together outside the womb, so they are uncoordinated. But if you are wondering when babies’ eyes change, the answer is around four months. Your baby’s eyes should straighten out after 4 to 6 months. If they do not align around your baby’s half-birthday, your baby’s uneven eyes may not be normal.2
Constant eye crossing, worsening eye alignment, or one eye consistently drifting may warrant earlier evaluation.
Related: 17 Weird but Normal Things About Newborn Babies
What If My Baby Is Still Cross-Eyed After 1 Year?
A pediatric ophthalmologist should evaluate babies who remain cross-eyed beyond 4 months. If they are still cross-eyed at 1 year of age, they may be diagnosed with strabismus. It is most often diagnosed between the ages of 1 and 4, but it can be diagnosed up until the age of 6.2
Your pediatrician should perform regular eye exams at your baby’s well-child visits. These are the best ways to detect crossed eyes. If the pediatrician notices crossed eyes during an exam of your baby, they may refer you to an eye doctor for further testing and treatment. It is essential to diagnose strabismus early to treat it effectively.2
What Causes Cross-Eyes in Babies?
Several factors can contribute to crossed or misaligned eyes in babies, ranging from temporary developmental changes to underlying vision or nerve conditions.
Prematurity
Premature babies are at risk for retinopathy of prematurity, in which blood vessels grow abnormally in the eye.17 This condition has been shown to increase the risk of crossed eyes.18
Related: Preemie Developmental Milestones: What To Expect
Family History
People with parents or siblings with strabismus are more likely to have it themselves. This suggests a genetic link to weakened eye muscles.19,20
Medical Conditions
In some cases of a cross-eyed baby, it is not the eye muscles at fault but the nerves that control those muscles. If your child has suffered a stroke or head injury, or has cerebral palsy or Down syndrome, their ocular nerves may struggle to make both eyes focus in alignment, causing crossed eyes.
In addition, rare medical conditions may affect your child’s vision, leading to cross-eyes or a “lazy eye” when one eye has a different vision from the other.20
Straining
If a child is vision-impaired with near- or far-sightedness, they may compensate by straining to see. This visual strain can cause the eyes to drift apart, misalign, and become crossed over time.21
Sometimes, crossed eyes in babies are temporary and improve with development, while other cases may require monitoring or treatment.
Related: Baby Vision Development by Age: Newborn to Infant
Ways To Support Healthy Eye Development
If you notice a cross-eyed baby, remember that this can be normal in the first four months of life. Their eye muscles may need to adjust to the outside world. During the first few months of life, simple visual activities may help support healthy eye coordination and tracking skills.
Support Visual Development
High-contrast images, such as black-and-white cards, are easier for your baby to focus on. Expose them to many images and environments.22
Practice Tracking
Hold an image or toy 8 to 10 inches from your infant’s face; this is the optimal distance for seeing until 4 months old. Slowly move the object from side to side, encouraging your cross-eyed baby to maintain their focus on it. You can also encourage object tracking by moving or turning your baby slowly around a room. This allows them to practice tracking objects and switching focus.22
Maintain Balance
Alternate the side that you hold your baby to feed, and switch up the side of the crib on which you lay them down to sleep. This allows both eyes to strengthen evenly as your baby looks out and practices seeing equally out of both eyes and turning their head in each direction.22
Related: What Color Eyes Will Your Baby Have?
When Do Babies’ Eyes Stop Crossing?
While it may be tempting to wait out your baby’s crossed eyes to see if they improve on their own, this will likely make them worse, not better. Persistent crossed eyes beyond early infancy are unlikely to improve without evaluation or treatment. As the stronger eye becomes more dominant, the crossed eye can become more prominent and “lazy.” 20
If your baby’s crossed eyes persist beyond four months, mention it to their primary care provider. You may be eager to fix your baby’s crossed eyes, but it is often best to leave this to professionals.
Treatment Options for Crossed Eyes in Babies
In the most common form of crossed eyes (strabismus), treatment is to strengthen the weaker eye. One common treatment approach is to encourage the weaker eye to work harder by temporarily limiting reliance on the stronger eye, thereby encouraging the child’s brain to work to focus with the weaker eye. You can achieve this using glasses or an eye patch. Very rarely, crossed eyes in babies may need surgical repair.2
Occasional crossed eyes can be a normal part of early visual development, especially during the first few months of life. As babies grow, their eye muscles and coordination typically become stronger and more aligned.
Still, persistent or worsening eye crossing should not be ignored. Early evaluation and treatment can make a significant difference in your child’s vision development and long-term eye health.2 If you have concerns about your baby’s eye alignment, your pediatrician or a pediatric ophthalmologist can help guide the next steps.
