Squints

Question 1

Define Strabismus

Answer 1

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.

Question 2

Epidemiology of Strabismus

Answer 2

Occurs in 2-4% of the population. It is a common presenting complaint of retinoblastoma. Risk factors are FHx and low birth weight

Question 3

Causes of Strabismus

Answer 3

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

Question 4

Management of Strabismus

Answer 4

Glasses
- Often improve misalignment

Patching the good eye
- Encourages the improvement in the affected eye through use

Surgery
- Last resort for correction

Question 5

Prognosis of Strabismus

Answer 5

Should be corrected before 4 months of age