Baby Crossed Eyes (Strabismus)
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, AAP, CDC guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect baby crossed eyes (strabismus), here is what the evidence says.
The short answer
It is common for newborns' eyes to occasionally cross or wander during the first 3-4 months as their eye muscles strengthen and coordination develops. This intermittent crossing usually resolves on its own. However, if one eye consistently turns in, out, up, or down after 4 months, or if crossing is constant at any age, it should be evaluated by a pediatric ophthalmologist.
Key takeaways
- It is common for newborns' eyes to occasionally cross or wander during the first 3-4 months as their eye muscles strengthen and coordination develops. This intermittent crossing usually resolves on its own. However, if one eye consistently turns in, out, up, or down after 4 months, or if crossing is constant at any age, it should be evaluated by a pediatric ophthalmologist.
- Usually normal when: Brief, intermittent crossing in a baby under 3-4 months old that comes and goes and is not constant
- Call your doctor if: One eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, CDC guidelines, it is common for newborns' eyes to occasionally cross or wander during the first 3-4 months as their eye muscles strengthen and coordination develops. This intermittent crossing usually resolves on its own. However, if one eye consistently turns in, out, up, or down after 4 months, or if crossing is constant at any age, it should be evaluated by a pediatric ophthalmologist. At 0-3 months, intermittent eye crossing in newborns is very common and usually not a cause for concern. Babies are still developing the coordination between their eye muscles and brain. Many babies also have pseudostrabismus, where a wide nasal bridge or prominent skin folds make the eyes appear crossed when they are actually aligned. True constant crossing at any age, however, should be evaluated. It is generally considered normal when brief, intermittent crossing in a baby under 3-4 months old that comes and goes and is not constant. However, you should contact your pediatrician promptly if one eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
Intermittent eye crossing in newborns is very common and usually not a cause for concern. Babies are still developing the coordination between their eye muscles and brain. Many babies also have pseudostrabismus, where a wide nasal bridge or prominent skin folds make the eyes appear crossed when they are actually aligned. True constant crossing at any age, however, should be evaluated.
3-6 months
By 4 months, a baby's eyes should be consistently aligned and able to track objects smoothly together. If crossing is still occurring regularly after 4 months, a referral to a pediatric ophthalmologist is recommended. Early detection is important because untreated strabismus can lead to amblyopia (lazy eye), where the brain starts to ignore signals from the misaligned eye.
6-12 months
Any persistent eye misalignment at this age needs evaluation. Treatment depends on the type and cause of strabismus and may include glasses, patching the stronger eye to strengthen the weaker one, or in some cases, surgery to adjust the eye muscles. The earlier treatment begins, the better the outcomes for visual development.
12 months+
Some children develop strabismus (particularly intermittent exotropia, where an eye turns outward) after infancy. New onset eye turning at any age should be evaluated. Children do not outgrow true strabismus, and early treatment is important for developing normal binocular vision and preventing permanent vision loss in the affected eye.
What to Tell Your Pediatrician
- Describe when you first noticed baby crossed eyes (strabismus) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby's eyes are still intermittently crossing after 4 months of age.
- Mention if you notice one eye consistently drifts inward, outward, upward, or downward while the other looks straight ahead.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Brief, intermittent crossing in a baby under 3-4 months old that comes and goes and is not constant
- Your baby's eyes appear slightly crossed due to a wide, flat nasal bridge (pseudostrabismus), but actually track together normally
- Both eyes move together smoothly to follow objects or faces after 3-4 months of age
- Your baby makes good eye contact and visually tracks objects across their field of vision
- Your baby's eyes are still intermittently crossing after 4 months of age
- You notice one eye consistently drifts inward, outward, upward, or downward while the other looks straight ahead
- Your baby seems to tilt or turn their head consistently to one side when looking at things
- You are not sure whether your baby's eyes are truly misaligned or if it is pseudostrabismus from their facial features
- One eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss
- Your baby develops a sudden new eye turn, especially if accompanied by a head tilt, eye swelling, or the pupil appears white in photographs instead of the normal red reflex
What You Can Do at Home
- Keep track of when you notice baby crossed eyes (strabismus) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that brief, intermittent crossing in a baby under 3-4 months old that comes and goes and is not constant — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if one eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is baby crossed eyes (strabismus) normal?
When should I call the doctor about baby crossed eyes (strabismus)?
When is baby crossed eyes (strabismus) normal?
What causes baby crossed eyes (strabismus)?
What should I mention to my pediatrician about baby crossed eyes (strabismus)?
Is baby crossed eyes (strabismus) normal at 0-3 months?
Is baby crossed eyes (strabismus) normal at 3-6 months?
Should I go to the ER for baby crossed eyes (strabismus)?
Does baby crossed eyes (strabismus) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Crossed Eyes (Strabismus).
Things to mention
- Describe when you first noticed baby crossed eyes (strabismus) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby's eyes are still intermittently crossing after 4 months of age.
- Mention if you notice one eye consistently drifts inward, outward, upward, or downward while the other looks straight ahead.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your baby's eyes are still intermittently crossing after 4 months of age
- You notice one eye consistently drifts inward, outward, upward, or downward while the other looks straight ahead
- Your baby seems to tilt or turn their head consistently to one side when looking at things
Urgent signs to report immediately
- One eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss
- Your baby develops a sudden new eye turn, especially if accompanied by a head tilt, eye swelling, or the pupil appears white in photographs instead of the normal red reflex
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Related Resources
Bottom line
Most cases of baby crossed eyes (strabismus) are normal. Talk to your pediatrician if one eye is constantly turned in a different direction from the other at any age, as this indicates true strabismus requiring prompt evaluation to prevent vision loss.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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