Define Strabismus
Strabismus is the term used to describe an anomaly of ocular alignment or a ‘squint’. Strabismus can occur in one or both eyes, and in any direction.
Epidemiology of Strabismus
Occurs in 2-4% of the population. It is a common presenting complaint of retinoblastoma. Risk factors are FHx and low birth weight
Causes of Strabismus
Commonly due to muscle/nerve problem, but can be a disorder of the brain.
Can be
- Intermittent - when tired
- Constant - muscle inability
Primary causes are:
- Idiopathic infantile esotropia
- Intermittent esotropia associated with various syndrome (Down’s, Marfan’s and Turner’s)
Secondary causes are:
- Restinoblastoma
- Head trauma with cranial nerve palsies (paresis of unknown cause)
- Orbital fracture
- Myasthenia gravis
- Graves’ disease
Management of Strabismus
Glasses
- Often improve misalignment
Patching the good eye
- Encourages the improvement in the affected eye through use
Surgery
- Last resort for correction
Prognosis of Strabismus
Should be corrected before 4 months of age
