Restrictions in the diagnoses and management of strabismus problems

Restrictions have been found to be a common cause of incomitant strabismus and limitation of ocular rotations. Different types of restrictions have been described and the technique of forced duction testing reviewed. Causes of restriction include endocrine eye disease, orbital floor and medical wall fracture, Brown's syndrome, tight lateral rectus syndrome, congenital tight muscles, scarring, muscle contracture, and orbital celluitis or tumors. The importance of recognizing restrictions in the management of these problems has been emphasized.