STRABISMUS: Ocular Misalignment

STRABISMUS: Ocular Misalignment Rule Out Amblyopia Phoria Latent deviationSymmetrical corneal light reflex, Negative cover test positive cover/uncover testTropiaManifest deviationAsymmetrical light reflex,Positive cover testStrabismus Esophoria (eye moves medial ? centre when uncovered) Exophoria (eye moves lateral ? centre when uncovered) CN VI problem (eye cannot abduct) Accommodative Esotropia (onset 2-4yrs, hyperopic) Congenital Esotropia (contralateral eye deviates medial ? straight when ipsilateral covered) Exotropia (contralateral eye deviates lateral ? straight when ipsilateral covered) Non-Paretic Comitant Angle of misalignment unchanged with direction of gazePareticNon-comitantAngle of misalignment changes with direction of gaze Horizontal (eso/exotropia) Horizontal and/or vertical (Eso/exotropia, hyper/hypotopia, mixed) CN III Problem (eye is depressed and abducted, ptosis, large/unreactive pupil) CN IV Problem (eye cannot depress when looking medially)Clinical Peal:Strabismus is most often seen in pediatrics.