Investigating strabismus (summary)

This is a basic article for medical students and other non-radiologists

Strabismus, commonly known as "crossed eyes" or "squint," is a visual disorder characterised by the misalignment of the eyes ¹.

Reference article

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Summary

• epidemiology

  • strabismus is a relatively common condition, affecting approximately 1-4% of the population ²

  • the disorder often develops during early childhood, although it can also occur in adulthood

  • the exact prevalence may vary by geographic region, genetics, and environmental factors

• pathophysiology

  • strabismus is primarily a result of the disruption in the balance of extraocular muscle function, which controls the movement and alignment of the eyes.

  • the pathophysiology of strabismus can be classified into various types, including esotropia (inward deviation of one or both eyes), exotropia (outward deviation), hypertropia (upward deviation), and hypotropia (downward deviation)

  • deviations may be constant or intermittent, and they can occur in one or both eye

• questions

  • was it in childhood or adulthood?

  • does the patient have a family history of strabismus or other eye disorders?

  • are there any associated visual symptoms such as double vision or blurred vision?

  • how do the eyes align under different conditions, such as distant and near vision?

  • is the deviation constant or intermittent?

  • does the patient have any other medical conditions or neurological disorders that could be related to strabismus?

• investigation

  • MRI and CT scans may be used to evaluate the extraocular muscles, the structures within the orbit, and the neurological aspects of strabismus

• common pathology

  • refractive errors

  • neurological factors (cranial nerve or brain centre lesions)

  • hereditary factors

  • eye muscle imbalance

  • trauma

  • thyroid eye disease

  • amblyopia

  • medications and drugs

• treatment

  • ocular treatments, e.g. corrective lenses, ocular patching, vision therapy

  • botulinum toxin

  • surgery

  • treatment of underlying conditions