"lazy eye" (adult strabismus) only in photos/on zoom but not in person?

November 20, 2023 4:15 PM

Been this way my whole life as I can recall. Why does this happen? Do others have this experience?

One of my eyes turns obviously inward in almost all photos and on video chat on my laptop. Friends, partners, and family have said that the eye looks totally normal "in person." I can't see anything off in the mirror since when I look at my eyes they are both focused directly on my reflection.

My optometrist (I wear glasses or contacts for a -3 in both eyes) also says she can't notice it (both by looking at me and testing that my eyes move together) and that if it happens it just means the one eye is "getting tired."

This seems baffling to me and ideally I would get corrective surgery, but if it's not observable in person I'm at a loss. Any ideas? I will most likely go to a second optometrist (or ophthalmologist) but wanted to know if this is typical.

posted by CancerSucks to Grab Bag (10 answers total)

Get another opinion, just to be sure. My strabismus wasn’t detected for years until a very thorough exam. Strabismus may also be hereditary so check with any siblings etc.

Do you have any old drivers licenses? Check those photos too. Its how my sibling confirmed his status.
posted by TDIpod at 4:39 PM on November 20, 2023 [2 favorites]

We thought our kid has strabismus when she was a baby, but it was pseudostrabismus. Possibly what's happening to you?:

Pseudostrabismus refers to the appearance of eye misalignment in the absence of true misalignment of the visual axes. The appearance of eye misalignment may be created by certain morphological features of the face (including the eyelids, interpupillary distance, and nose) or an abnormal angle kappa
posted by tristeza at 4:53 PM on November 20, 2023 [2 favorites]

Can you take a video of yourself, and show that to your optometrist? Maybe to a different optometrist than the one you've seen recently.
posted by samthemander at 11:44 PM on November 20, 2023

My grandfather had strabismus that was MUCH more obvious in photographs than in person - this can happen! I don't know if it's what's happening to you, but it's possible.
posted by branca at 5:56 AM on November 21, 2023 [1 favorite]

Best answer: Is it possible you have amblyopia and not strabismus? Strabismus is more of a fixed condition, whereas amblyopia can manifest more when you are tired, trying to fix your gaze on an object, etc.

Note that the conditions can co-exist. But what you describe sounds like amblyopia -- when you're specifically trying to fix your gaze on the screen during zoom calls or at a person holding a camera, taking a selfie, you're trying to hold your eyes on something and the "lazy" eye is going to turn inward. (I also have this.)

When you're socializing or doing things that don't require a fixed gaze, you're probably moving your eyes and head around enough that the "lazy" eye is in motion too much to notice the tendency to drift inwards.
posted by jzb at 7:04 AM on November 21, 2023 [1 favorite]

I had corrective surgery for amblyopia in one eye at age seven that mostly fixed it in the sense that they now track very well together, but it does still manifest along the lines of what you describe. It indeed gets worse when I've been using the eyes a lot ("the eye is tired"), and is significantly impacted by non-optimal correction of the vision in that eye for the distance I'm trying to use it at. It's also possible that the relatively dynamic nature of social interactions versus looking at a camera is skewing your data, since in-person you're free to subconsciously compensate. And it's also definitely true that other people's perception of the issue isn't necessarily accurate: friends routinely claim they can't see anything "wrong" with my eye (and in my case the amblyopia is the least of it), yet almost all children I meet notice immediately, so.

If you'd ideally get surgery, you do want an ophthalmologist. Getting in with one on the strength of a non-urgent referral for something that's not affecting your vision will probably be a long process, but they at least should be able to give a definitive answer.
posted by teremala at 7:10 AM on November 21, 2023 [2 favorites]

Response by poster: jzb - this must be the case because I strongly remember the word amblyopia being used when I was first getting eye exams as a child! Does this condition respond to surgery or anything else? (Or have you found a technique to take better pictures?)

The fact that photos and video calls are so important professionally and socially now makes me want to fix it.
posted by CancerSucks at 8:31 AM on November 21, 2023

Does this condition respond to surgery or anything else? (Or have you found a technique to take better pictures?)

Coming in here to address specifically this, because my brother had amblyopia as a child and it was fixed without surgery. However - it was fixed through him wearing an eyepatch over one eye or the other for a handful of years, and then glasses with a corrective lens over one eye and then plain glass in the other. However - I think one of the reasons that it worked as well as it did (he doesn't need anything at all now, and he's 50) is that the doctors started treating him when he was only about 5, and his eyes were still kind of "cooking". This may be something that's easier to treat the younger you catch it.

I am not a doctor, though, and this is not medical advice - it a recollected anecdote from the early 1980s.
posted by EmpressCallipygos at 12:42 PM on November 21, 2023

Does this condition respond to surgery or anything else? (Or have you found a technique to take better pictures?)

I haven't pursued surgery so I can't really say. I have a fair amount of corrective prism in my glasses to correct my tendency to "drift" but I was noticing late enough in life that I wasn't encouraged to pursue surgery, etc.

For pictures - my amblyopia is really the least of my problems, looks-wise, so I haven't worried about it too much. ;-) But, in all seriousness, I just try not to over-focus on the person / camera and look a bit past them and it usually seems to work? I have a hell of a time taking selfies without it showing up, though.
posted by jzb at 1:15 PM on November 21, 2023

(JFYI if you are talking with medical people, "strabismus" is a thing with eye alignment. "Amblyopia" is when the brain ignores the input from one eye. During childhood, strabismus can lead to amblyopia, when the brain can't align the two inputs and ignores one. Later in life, you could fix the visible strabismus but the brain has already learned to disregard one eye.)
posted by away for regrooving at 9:37 PM on November 21, 2023