- Does it affect the cat's balance (or negatively in any other way)?
- Can (or should) it be corrected?
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Strabismus the medical name for this condition. It can affect one or both eyes, and the eyes may tend towards any particular direction (not just inwards). Siamese cats breed from the original stock given to the Europeans tend to inherient this trait because they were culls (unknown to the Europeans!).
(As an aside, the cat in the picture lacks the distinctive colorpoints that usually indicate Siamese ancestry, but the blue eyes are a common characteristic of the breed not usually seen in other breeds, so I suspect this cat does have some amount of Siamese/Oriental ancestry).
- an imbalance of extraocular (outside of the eye) muscle tone,
something decreasing the mobility of the muscles surrounding the eye
- Restriction of eye muscle mobility from scar tissue (usually from previous trauma or inflammation)
- Abnormal crossing of visual fibers in the central nervous system
There was a study done where cats were inflicted (surgically) with strabismus and their ability to jump was judged over time. Kittens were able to adapt to the strabismus, while adult cats were less able to adapt.
So, if you're looking at adopting a kitten with strabismus, the cat will learn to adjust and you shouldn't expect any problems.
If you're adopting an adult and the onset of the strabismus is unknown, then you may need to observe the cat to determine how well he/she is able to compensate. I wouldn't have any concerns adopting a cat with clear Siamese heritage (3 of my 4 cats are from the Siamese Rescue Center) because it's likely that that cat has had strabismus from birth and was able to adapt as a kitten.
There's no reason to correct genetic strabismus (that was present from birth). It's a cosmetic condition once the cat has learned to adjust for the condition.
If your cat has normal eyes and suddenly one (or both) become cross eyed (or otherwise turned in an odd direction), then you should immediately take your cat to the vet. Your cat may be sick or injured and it needs to be examined immediately.
In some cats (Siamese among them), crossed eyes can actually be the cat's way of compensating for a neurological abnormality in which the optic nerves split so part of each eye's vision is reaching both hemispheres of the brain rather than one each. Some cats with this condition may also, or instead, continuously move their gaze back and forth a bit (integrating over time?) It's genetic/congenital, and mostly harmless in pet cats whose survival doesn't require peak health.
(My half-siamese had the moving-gaze symptom, sometimes. "Cat, you're woggling again...")
I'll also note that in the worst case, the special care needed -- assuming this is NOT an indication of current/recent injury or bad health -- would be akin to that needed for a cat whose vision was impaired for other reasons. Try to avoid moving furniture/litterbox/food bowls unnecessarily, try to keep "landing surfaces" clear of objects the cat might either fall over or knock over (a good idea anyway), that sort of thing. But you'll quickly learn just how much the cat can or can't see and how much assistance it needs.
In Siamese cats it was a corrective effect since their retina turned inward due to a genetic trait linked to their blue eyes I think. They don't all have it now since breeders have tried to eliminate it. http://pets.thenest.com/normal-siamese-cat-crosseyed-8836.html