Waking up with crossing eyes: Eva’s journey with strabismus

Early one morning, 8-year-old Eva came out of her room rubbing her eye — she told her mom, Jennifer, that her eye was feeling “weird.”

Jennifer examined Eva’s eye and was concerned to find that Eva’s left eye was drifting inward toward her nose. This was not typical for Eva, who never had eyesight problems in the past. In fact, she had 20/20 vision. Fearing the worst, Jennifer quickly took Eva to her pediatrician.

Eva and Jennifer were urgently referred to the Julia and George Argyros Emergency Department at CHOC Hospital in Orange.

No definitive cause of strabismus for Eva

After Brain imaging and other tests, CHOC experts ruled out alarming conditions like a tumor or brain bleed. Eva and Jennifer were sent home from the hospital, but they didn’t have any definitive answers for what had gone awry with Eva’s eyesight.

Eva and her siblings, Nolan and Jade, at a spring event in 2019

At her first appointment with Dr. Rahul Bhola, medical director of CHOC ophthalmology, it became clear that Eva had acute onset strabismus, a condition where the eyes do not line up with each other. This caused debilitating double vision and headaches for Eva.

“When a child of Eva’s age presents with strabismus, it can be very worrying,” says Dr. Bhola. “Thankfully, the testing carried out at the emergency department ruled out anything life threatening, and we were able to direct our attention to resolving her double vision.”

Undergoing strabismus surgery

After Jennifer and Eva tried some early intervention techniques like wearing an eye patch, Dr. Bhola determined it was time to pursue surgery.

Strabismus surgery is a delicate procedure where the muscles that move the eyes are strengthened or weakened to improve the alignment of the eyes and balance the vector forces responsible for eye movements.

Dr. Bhola has been performing strabismus surgeries for over 20 years, but every case is unique and provides a new challenge. With Eva, he says, correcting her double vision and restoring her binocular vision, or 3-D vision, was paramount. Delaying the surgery could have had a significant impact on her outcome, causing impaired binocular vision and depth perception.

Eva underwent surgery in April 2019. Since her case of strabismus was particularly severe with her left eye angling about 60 degrees inward, Dr. Bhola prepared Eva and her family for the possibility of more than one surgery to correct the misalignment of her eyes.

Eva on the day of her strabismus surgery at CHOC Hospital in Orange

Once the anesthesia wore off, Eva declared, “Mom, I can see perfectly. I don’t have any double vision anymore.”

She had forgotten what it was like to see bright colors.

In June 2019, Dr. Bhola cleared Eva — one surgery was enough. After a stint with glasses for a few months due to eye strain from attending class online during the pandemic, today, Eva doesn’t need glasses at all.

Looking ahead – with aligned eyes

Even prior to the surgery with trouble seeing the board in class, Eva never let her grades slip. She stayed positive and toughed it out. Now back to her 20/20 vision, she’s still going strong. She’s smart, active and loves to sing, says Jennifer.

Eva, in 2021, with her 20/20 vision restored

Jennifer and Eva consider Dr. Bhola an honorary member of their family. His team at CHOC turned a scary experience into a positive one, and they are so grateful.

For other families that may be going through strabismus or vision problems with their kids, Dr. Bhola advises, “There are many causes of strabismus. The onset is typically in early childhood, but it can occur at any age. If you are concerned your child may have strabismus, the best course of action is to consult with a pediatric ophthalmologist.

Jennifer adds to never give up hope. She says, “There’s always the possibility that it can be OK. Trust the talent and expertise of your medical team — especially if they are from CHOC.”  

For more about ophthalmology at CHOC