Eye Movement Disorders

Strabismus, Nystagmus, and Amblyopia

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Duke neuro-ophthalmologists and pediatric ophthalmologists identify the cause of eye movement disorders including double vision, shaky vision, crossed eyes (strabismus), and involuntary eye movements (nystagmus). We work with people of all ages who have eye movement disorders. Our goal is to identify the cause of your eye movement disorder and help you receive the most effective treatment.

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Consultation for Eye Movement Disorders

You or your child may be referred to one of our pediatric ophthalmologists and/or neuro-ophthalmologists for vision problems related to strabismus, nystagmus, or another eye movement disorder. These conditions can be present at birth, acquired at an early age, or develop in later childhood and adulthood. We use sophisticated testing to determine the cause of your symptoms. We work with specialists throughout Duke Health to help you and your child understand your condition and choose the most appropriate treatment.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Treatments for Eye Movement Disorders

Eye Patches

Eye patches reduce the risk of amblyopia (lazy eye) and loss of sight in children with strabismus. Eye patches can also be used to manage double vision. The goal is to eliminate double vision by blocking the images produced by one eye.

Corrective Lenses

Eyeglasses and contact lenses can sometimes help straighten the eyes by reducing their focusing effort.


Special lenses alter the light entering the eye, which can help eliminate double vision in patients with strabismus.

Vision Therapy/Orthoptic Eye Exercises

Computer and optical devices are used to correct some specific eye movement disorders through visual-motor-skill and endurance exercises.

Eye Muscle Surgery

Surgery may be recommended for certain patients to change the eye alignment so that the brain can use both eyes together. Surgery weakens or strengthens one or more of the six muscles attached to the outside of the eyeball, depending on the particular case. Surgery to realign the eyes may be performed in steps, requiring more than one operation.

Extensive Evaluation

We conduct an extensive and thorough evaluation that may take three to four hours to complete. The evaluation is tailored to your or your child's specific symptoms. It will include a complete medical history and an examination of your eyes, including close inspection of your retina and optic nerve. The following tests may be conducted.

Visual Acuity

This test measures the extent to which vision is affected by the eye movement disorder. 

Orthoptic Measures or Eye Movement Analysis

Your doctor and/or an eye movement specialist (called an orthoptist) measures eye alignment and the coordination between the eyes in all positions.

Genetic Testing

When hereditary eye movement disorders are suspected, genetic testing may be recommended.

Neurological Testing

If your doctor thinks eye misalignment could be related to a brain issue, you or your child may undergo an MRI or CT scan of the brain, a lumbar puncture, and/or blood work.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

Advanced Subspecialists
Pediatric ophthalmologists and neuro-ophthalmologists undergo advanced ophthalmology or neurology training by completing fellowship training focused on understanding how the brain affects eye movements.

Experienced Pediatric Specialists
Two of our neuro-ophthalmologists have also completed a separate fellowship in pediatric ophthalmology and strabismus. This includes advanced training in ocular misalignment and other eye conditions that affect children.

Team Approach
We work closely with neurologists, neurosurgeons, and other specialists throughout Duke Health to ensure you or your child receives the best possible care.

National Leaders in Neuro-Ophthalmology and Pediatric Ophthalmology
Our neuro-ophthalmologists and pediatric ophthalmologists lecture and train on the latest advances in eye care around the world and publish research in their specialized field.

Comprehensive Support
Our clinical social worker is available to help you r your child cope with the emotional and psychological stress of eye misalignment/double vision, as well as other medical or environmental concerns.

This page was medically reviewed on 05/31/2022 by