3 Uncorrected refractive abnormalities, such as myopia and hyperopia, may also result in secondary strabismus via a similar mechanism. However, amblyopia can paradoxically also be a cause of secondary strabismus, as a degraded visual experience in one eye may result in that eye drifting out of correct alignment. Intracranial/intraorbital/intraocular mass (benign or malignant)Īmblyopia is a recognised consequence of established strabismus (either primary or secondary). Common causes of strabismus 1 Primary causes of strabismus 7 Secondary strabismus is often associated with neurological pathology, such as intracranial tumours, head trauma, infection and autoimmune disorders. Recognised risk factors for primary strabismus include a family history of strabismus, premature birth and a low birth weight. Common causes of childhood strabismus are listed in Table 1.
Strabismus can be either primary or secondary (acquired). For this reason, GPs should be alert to this common problem and be familiar with practical screening tests that may unmask situations requiring specialist referral. 3,6 Nonetheless, the cost–benefit value of these public health programs is the subject of ongoing debate, 6 and the lack of a national Australian screening program necessitates that individual assessment of children currently falls into the realms of primary care clinicians, such as general practitioners (GPs), and maternal and child health nurses.
As patients with paediatric strabismus usually present before school age (with an average onset at 1–4 years), population-based pre-school screening programs have been advocated as a way to reduce the rate of untreated strabismus and amblyopia. Nonetheless, many cases of strabismus go unrecognised. Early detection and treatment improves vision outcomes and psychosocial wellbeing for children with strabismus.
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