Strabismus in childhood

We have discussed what constitutes a normal visual and ocular system in children and the inherent mechanisms that help each person develop and maintain normal visual function. This ideal status should include good visual acuity in each eye, straight eyes, and the development of fusion. Strabismus represents an obstacle to obtaining these goals and may be caused by poor vision, refractive errors, or anatomic, structural, or innervational abnormalities. Each of these conditions is treatable and correctable when discovered early. With early identification, proper treatment can be instituted and the patient can have the opportunity to develop optimal vision with fusion and depth perception -- a lifetime benefit. Several other types of strabismus respond poorly to the use of glasses, prisms, exercises, or medications and can be effectively treated only by surgical methods. Most divergent and vertical deviations fall into this group, as do ocular deviations associated with paretic or structurally abnormal muscles.