Crossed Eyes (Strabismus) in Cats

Key Takeaways

Crossed eyes (strabismus) is a common symptom in cats where one or both eyes have abnormal, persistent positioning. 

• Strabismus can be congenital and is most often seen in Siamese, Himalayan, and flame point Persian breeds

• Crossed eyes can also develop suddenly and is most often a symptom of another underlying issue with the eyes, inner ear, or brain

• Common causes include congenital diseases or deformities, injury, meningitis, feline leukemia virus, cancer, inner ear disorders, and other infections leading to inflammation

• Diagnostics depend on whether other symptoms are present or not but may include a physical examination, neurological examination, diagnostic imaging, blood work, and urinalysis

• Treatment depends on the underlying condition but can include surgery, antibiotics, anti-inflammatories, and physical therapy

• Prognosis ranges from good to guarded depending on the underlying condition

A Closer Look: What is Strabismus in Cats?

Strabismus is a common symptom in cats. If the symptom is congenital (present at birth), this is not often a severe symptom and affected cats generally adjust well and have a high quality of life.

Possible Causes

Causes of strabismus can be broadly divided into two categories:

Congenital: Most often seen in Siamese, Himalayan, and flame point Persian breeds

Acquired: causes include

• Brain or nervous system cancer

• Inner ear disorders

• Physical trauma to the ear, inner ear, or brain

• Feline leukemia virus

• Hydrocephalus

• Inflammation

• Meningitis

Risk Factors

Strabismus  can affect one eye or both. If it occurs rapidly or is accompanied by other neurological symptoms, this may be a more severe presentation associated with dangerous conditions. Congenital strabismus is common in Siamese, Himalayan, and flame point Persian cats.

Sudden onset of strabismus can be a sign of severe and potentially life-threatening conditions and requires emergency veterinary care.

Testing and Diagnosis

Diagnostics involve a physical examination, medical history, diagnostic imaging, blood work, urinalysis, and a full neurologic examination. Neurologic investigation may require referral to a specialist. 

Treatment depends on the root cause of the crossed eyes but can include;

• Medications (anti-inflammatories, antibiotics)

• Surgery

• Physical therapy

• Symptom management (such as anti-nausea medications)

Similar symptoms

Strabismus is self evident and not likely to be confused with other symptoms. Other symptoms that impact symmetry of the eyes are similar but distinct. Examples include protrusion of the third eyelid and sunken or bulging eyeballs.

Associated Symptoms

Other neurologic signs often accompany acquired cases of strabismus. These include:

• Nystagmus

• Head tilting

• Seizures

• Lethargy