Abstract
OBJECTIVE: To review the clinical classification of strabismus, to describe the timing and method of strabismus screening examinations, and to discuss the principles of treatment. QUALITY OF EVIDENCE: Current literature (1983 to 1995) was searched via MEDLINE using the MeSH headings strabismus, ocular motility disorders, and amblyopia. Articles were selected based on their date of publication, clinical relevance, and availability. Preference was given to more recent articles, articles with large numbers of subjects, and well-designed cohort studies. Official recommendations from academic groups were analyzed. Descriptions of clinical tests and their illustrations are based on classic texts. MAIN FINDINGS: Primary care physicians should screen all low-risk children. High-risk children (low birth weight, family history of strabismus, congenital ocular abnormality, or systemic conditions with vision-threatening ocular manifestations) should be referred to an ophthalmologist for screening. Screening should be performed in the neonatal period, at 6 months, and at 3 years (Grade A recommendation), as well as at 5 to 6 years (Grade B recommendation). Screening examination includes inspection, examining visual acuity, determining pupillary reactions, checking ocular alignment, testing eye movements, and ophthalmoscopy. CONCLUSIONS: Primary care physicians are essential to early detection of strabismus and amblyopia. Early detection can help minimize visual dysfunction, allow for normal development of binocular vision and depth perception, and prevent psychosocial dysfunction.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Catalano J. D. Strabismus. Pediatr Ann. 1990 May;19(5):289, 292-7. doi: 10.3928/0090-4481-19900501-05. [DOI] [PubMed] [Google Scholar]
- De Becker I., MacPherson H. J., LaRoche G. R., Braunstein J., Cottle R., McIntyre L. L., Kozousek V. Negative predictive value of a population-based preschool vision screening program. Ophthalmology. 1992 Jun;99(6):998–1003. doi: 10.1016/s0161-6420(92)31865-2. [DOI] [PubMed] [Google Scholar]
- Deutsch J. A., Nelson L. B. Diagnosis and management of childhood strabismus. Pediatrician. 1990;17(3):152–162. [PubMed] [Google Scholar]
- Ing M. R. Early surgical alignment for congenital esotropia. J Pediatr Ophthalmol Strabismus. 1983 Jan-Feb;20(1):11–18. doi: 10.3928/0191-3913-19830101-02. [DOI] [PubMed] [Google Scholar]
- Lavrich J. B., Nelson L. B. Diagnosis and treatment of strabismus disorders. Pediatr Clin North Am. 1993 Aug;40(4):737–752. doi: 10.1016/s0031-3955(16)38584-4. [DOI] [PubMed] [Google Scholar]
- Manny R. E., Martinez A. T., Fern K. D. Testing stereopsis in the preschool child: is it clinically useful? J Pediatr Ophthalmol Strabismus. 1991 Jul-Aug;28(4):223–231. doi: 10.3928/0191-3913-19910701-09. [DOI] [PubMed] [Google Scholar]
- Rubin S. E., Nelson L. B. Amblyopia. Diagnosis and management. Pediatr Clin North Am. 1993 Aug;40(4):727–735. [PubMed] [Google Scholar]
- Satterfield D., Keltner J. L., Morrison T. L. Psychosocial aspects of strabismus study. Arch Ophthalmol. 1993 Aug;111(8):1100–1105. doi: 10.1001/archopht.1993.01090080096024. [DOI] [PubMed] [Google Scholar]
- Simons H. D., Grisham J. D. Binocular anomalies and reading problems. J Am Optom Assoc. 1987 Jul;58(7):578–587. [PubMed] [Google Scholar]
- Tychsen L., Lisberger S. G. Maldevelopment of visual motion processing in humans who had strabismus with onset in infancy. J Neurosci. 1986 Sep;6(9):2495–2508. doi: 10.1523/JNEUROSCI.06-09-02495.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watts J. Squint. Practitioner. 1989 Nov 22;233(1479):1553–1556. [PubMed] [Google Scholar]
