Children whose eyes are misaligned and point outward are at significantly increased risk of developing mental illness by early adulthood, according to findings of a Mayo Clinic study published this month in Pediatrics (http://pediatrics.aappublications.org/cgi/content/full/122/5/1033), the official journal of the American Academy of Pediatrics.

The retrospective study examined the medical records of 407 patients with strabismus (misaligned eyes) and compared them with records of children matched for age and sex but with normal eye alignment. Children with eyes that diverged (exotropia) were three times more likely to develop a psychiatric disorder than were the control subjects, while those with inward deviating eyes (esotropia) showed no increase in the incidence of mental illnesses.

Brian Mohney, M.D., the Mayo Clinic pediatric ophthalmologist who led the study, says the results can help alert physicians to potential problems in their pediatric patients. "Pediatricians and family practice physicians who see children with strabismus should be aware of the increased risk of mental illness," says Dr. Mohney. "They can hopefully be alert to the earliest signs of psychiatric problems in patients with exotropia, so they can consider having them seen by a psychologist or psychiatrist."

Strabismus is a misalignment of the eyes that affects three to five percent of children, and about 125,000 new cases are diagnosed each year in the United States.