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People With Visible Eye Deformities Face Prejudice

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June 20, 2000 -- "Don't cross your eyes or they'll stay that way!" It's even more serious than the threat mothers have used on children who purposely crossed their eyes to get attention. An eye that "stays that way" brings adults a type of attention they don't want, according to a recent study.

Adults with misaligned eyes -- with one eye that either turns out or in -- often report difficulties dealing with people and obtaining employment because of their appearance, according to a recent report in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

Because of the negative effects this condition can have on a person's quality of life, many doctors now believe that these adults should undergo corrective surgery, even if it doesn't improve their vision.

Having an eye that does not line up with the other is called strabismus, or more commonly, 'crossed eyes' or 'lazy eye.' When a child is diagnosed with this condition, doctors are more likely to suggest surgery, along with glasses and patching the eyes as needed, for correction because children are more likely to gain a vision benefit, such as getting the eyes to work together to gain depth perception.

This benefit is not as common in adults, so doctors do not frequently recommend surgery. And corrective surgery has been considered 'cosmetic,' so many insurance companies don't cover it.

"People with strabismus don't just have a self-esteem problem, they also have problems with the way other people view them," says Scott E. Olitsky, MD, of the department of ophthalmology of the State University of New York at Buffalo. "Because they don't look normal and because eye contact and people's facial features are so important in everyday life, they clearly are at risk of not getting certain jobs and are less likely to advance in the workplace. Discrimination, although it's a strong word, is a word that comes into play here.

"These people are not looking to be made cosmetically more attractive -- they just want to be made to look normal," Olitsky says.

One adult patient agrees. "He has done a miracle," he says of his doctor, Arthur L. Rosenbaum, MD, who performed successful corrective surgery. After seven previous unsuccessful surgeries to correct a right 'lazy eye,' this patient, in his 30s, reports newly found confidence and an "uplifting of my shoulders. ? I perform better and give my best. It has had a huge effect on my life," he tells WebMD.

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