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Q. My 5-week-old baby has cross-eye after removing an eyelash. Have I damaged his eye muscles?

Answered by
Dr. Arnab Pal
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 17, 2020

Hello doctor,

My baby is 5 weeks old. Yesterday, I used a cotton bud to remove an eyelash in the corner of his eye. It was right inside the edge of the eye. I did pull outwards to try and get it out. I did this for about two minutes before it finally came out. The next day his eyes are crossed. The eye I worked on is looking outside (wall-eyed), and I am worried I have damaged his eye muscle. Will this get better, or should I see an eye expert?

Dr. Arnab Pal

Ophthalmology (Eye Care)
#

Hello,

Welcome to icliniq.com.

I saw the pictures of your baby (attachment removed to protect patient identity). He is really super cute. Now coming back to your query about your child's eyes, let me assure you god has not made our eyes so weak. Please do not beat yourself up by thinking that such a minor thing, like what you did, could ever damage your child's eye or its muscles. It is not what has happened. Let me reassure you first by telling you that you have not damaged his eye muscles. Secondly, any such squinting of infants' eyes below 6 months of age do not hold any significance, because below 6 months, the eyes are not visually developed enough to keep them together straight and aligned together. So in a five weeks child, it's fairly common. Any squint which stays beyond 6 months needs to be checked up by a pediatric ophthalmologist. But nothing needs to be done in a squinting child below 6 months age as most squints go away by the time child turns 6 months old. There are a few red flag signs which need immediate attention.

1) Premature delivery with birth weight <1.7 kg. These children's eyes need a check-up for retinopathy of prematurity or ROP at one month of age.

2) White pupillary reflex/cats eye reflex.

3) Child not turning eyes towards torchlight in a semi-dark room or not seeming to notice toys near to face (cover one eye and test the other eye). There might be a chance that your child might see a bit less in the squinting eye than in the normal eye. But hold forth for 6 months. If squint stays, get the eyes checked up.

I hope this helps.


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Hello doctor,

Thank you for your kind response.

Dr. Arnab Pal

Ophthalmology (Eye Care)
#

Hello,

Welcome back to icliniq.com.

Do let me know if you have any other questions.


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Thank you doctor,

My only concern is other people I asked said their baby had such a problem from birth where there seem cross-eyed. But my baby only became crossed eyed from 5 weeks old and not from birth. That is why I am worried if I did this damage. Is it common for a baby to develop such overnight? Also, is it normal the crossed outward is occuring almost all the time especially when he looks at a distance like almost all the time? Is there anything I can do to help strengthen it?

Dr. Arnab Pal

Ophthalmology (Eye Care)
#

Hello,

Welcome back to icliniq.com.

I understand your apprehension about being a mom. I refuse to buy the theory that you have damaged his eyes. Our eye muscles are very strong. And it is impossible to damage them by such a superficial process. There is indeed a term called infantile exotropia, which occurs since birth or a few weeks from birth. However, it is not as urgent as infantile esotropia (eye inwards), which can cause a lazy eye very fast and requires surgery as soon as possible.

There are mainly two possibilities.

1) Child is not seeing well due to refractive error or any other ocular problems. But a 5-week child is normally quite weak visually. If you want you can definitely have the child's eye checked up by an ophthalmologist for excluding congenital cataract/retina problem or glaucoma. If all are normal, get cycloplegic retinoscopy done after six months of age.

2) If all are fine (eye power and other things as mentioned), then it may be your child's eye muscles are weak (infantile exotropia). I am sorry, but there are no exercises to strengthen them at this age. Exercises can be comprehended by the child only after 8-9 years of age. Surgery for infantile exotropia is dicey. Some favor early surgery, but as it is not urgent, I personally like most pediatric ophthalmologist operate only after six years of age.

Is the squint alternating between eyes because it is a good sign because it means bothered have equal vision. However, if one eye is predominantly squinting, then that eye presumably has lower vision. But again, all these talks of vision in a 5-week old is as meaningless as not carrying an umbrella in manchester. The child is yet to develop his full potential of vision, and once he does, squint will go away.

I tell you it is not urgent or dangerous. Definitely, you can get his eyes checked up once now. And then again after six months if squint persists.


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Thank you doctor,

Yes, it alternates now and again sometimes it is the right sometimes it is the left. No problem. I will just watch and pray and hope it sorts itself out. I have just never seen a baby have it before.

Dr. Arnab Pal

Ophthalmology (Eye Care)
#

Hello,

Welcome back to icliniq.com.

Good signs then. It is difficult when your own baby has it. Remember those red flag signs. Observe the baby and his eye movements and how he looks at toys, at your face, and lights. Look out for any white reflex inside the eye or if he prefers not to look at lights and seems averse to light.


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