Can congenital strabismus be inherited to the next generation?

Patient's question:

Please ask, will my boyfriend's strabismus be inherited? Neither of my parents have it, but why were both of my children strabismic? He and his sister are both strabismic, and it's severe. I'm very anxious, this concerns my future, our marriage, I'm very anxious!

Doctor's answer:

Congenital strabismus is generally influenced by familial genetic factors, and it can occur either at birth or within the first 6 months of life. The deviation angle is usually significant, often, and cannot be corrected solely by wearing glasses. The absence of binocular vision makes it the most harmful to visual function.
Recommendation: Strabismus present from birth is primarily caused by issues with the nerves controlling the eye muscles or the muscles themselves. Therefore, conservative treatment is largely ineffective, and surgical intervention is the main approach.
Strabismus surgery is generally risk-free, with most risks associated with the need for general anesthesia in children. The surgery itself involves adjusting the length of the eye muscles to strengthen or weaken them in a specific direction, thereby correcting the strabismus. The procedure does not cause vision loss and, on the contrary, significantly aids in the normal development of the child's visual function.
If a child has strabismus from a young age, the deviated eye may be suppressed over time, leading to amblyopia and affecting the development of simultaneous vision, stereoscopic vision, and fusion vision. Therefore, it is generally recommended to undergo surgery as early as possible.

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