June Week 1: Strabismus


Pediatric Vision Screening.  Gary L Rogers, MD and Catherine Olson Jordan, MD. Pediatrics in Review. March 2013.

Amblyopia: Etiology, Detection and Treatment. Irene Magramm. Pediatrics in Review. 1992.


You are seeing a 2-week-old patient for his WCC.  His mother mentions that he’s doing well overall, but he occasionally looks “cross-eyed” causing her some concern.

1. What do you tell her?  When does this finding become pathologic?

2. When you are worried about strabisumus, what test is diagnostic and how is it performed?

3. What is pseudostrabimus?  What additional test helps to differentiate pseudostrabismus from true strabismus?

You have just diagnosed a 2 yo boy with esotropia, the most common type of strabismus.

1. What is the major complication of strabismus and the reason for early detection and management?

2. When has the visual system fully matured? i.e. When is it considered too late to make the diagnosis in order to save vision?

3. You send this patient to a pediatric ophthalmologist and they diagnose him with accomodative esotropia.  What is this and how is it treated?  How is realignment achieved in most other types of strabismus?

4. The pediatric ophthalmologist also wants to start amblyopia therapy. What techniques exist for this?