1. Intro to Diagnosis & Management of Strabismus - Clinical Binocular Vision Fall 2026

What is strabismus?

Condition in which binocular fixation DOES NOT occur under normal viewing conditions

What are some other terms for strabismus?

-heterotropia

-tropia

-squint

-strab

Why do we care about strabismus and amblyopia?

-It is relatively common

-Can occur in Peds and Adults

-Much of management can be done in a primary care setting

-Dx and Management is an important part of good primary care optometry

-Prevention of permanent vision loss

The Baltimore Pediatric Eye Disease Study estimated the prevalence of strabismus to be what % of the population?

2-3%

The Baltimore Pediatric Eye Disease Study estimated the prevalence of esotropia/exotropia to be what % of the population?

1-2%

The Baltimore Pediatric Eye Disease Study estimated the prevalence of amblyopia to be what % of the population?

1-2%

Can strabismus occur in both adults and pediatric patients?

Yes

What are some of the visual consequences of strabismus?

-Amblyopia

-Suppression

-Reduced/absent stereo

-Diplopia

-Asthenopia/visual symptoms in some patients

-Protection of the other eye

Patients with strabismus exhibit significantly higher _____ and ____ distress than most patients without strabismus

psychosocial; physical

Patients with strabismus are generally more ____ about their appearance than the general population

self-conscious

Children and adolescents with strabismus scored (lower/higher) on health-related quality of life scales

lower

What is strabismus negatively associated with?

-physical well being

-emotional well being

-self esteem

-friends/peer relationships

What quality was the most consistent and strongest factor that was affected negatively by strabismus?

friends/peer relationships

True or False:

Mental health problems are more frequent in children with strabismus

true

Effect of Adult Strabismus on Ratings of Official US Army Photographs Study (Pic)

**how people perceive adults w/ strabismus

Effect of Adult Strabismus on Ratings of Official US Army Photographs Study (Pic)

What was the Adult Strabismus on Ratings of Official US Army Photographs Study testing?

They altered photographs of people wearing military regalia and asked people to rate the individuals promotability based on the photos alone

______ photos ranked significantly lower than orthophoric (or exo) pictures in the Adult Strabismus on Ratings of Official US Army Photographs Study

Esotropic

When headhunters were asked to judge photos of individuals with exo/esotropias, individuals with a visible strabismus were perceived as what?

-Less intelligent

-Less attractive

______% of headhunters believed strabismus made finding employment more difficult

72.5

_______ was perceived more negative than ______ in the strabismus and employability study

exotropia, esotropia

True or False:

Strabismus has an impact on economic status and can have psychosocial and social impacts

true

Psychosocial Aspects of Adults with Strabismus

-86% reported embarrassment of appearance

-89% reported difficulty making eye contact

-84% reported negative self esteem

-75% reported developing mannerisms to camoflage strabismus

True or False:

In patients with strabismus, calculated pre-operative self esteem, self confidence, and perceived intelligence improved following strabismus sx

true

What psychosocial aspects improve after pediatric strabismus sx?

-Eye related health related quality of life

-Psychosocial well being improved

-Improvement seen across strabismus subgroups

True or False:

Treatment of strabismus can improve outcomes beyond ocular alignment

true

What is the lifetime risk of serious vision loss in both eyes in amblyopic patients?

1.2-3.3%

Patients with amblyopia are at greater risk of losing vision in the sound eye d/t ____

trauma

Are strabismus and amblyopia common conditions that will be encountered in clinical practice?

Yes

Is diagnosis of strabismus and amblyopia an important part of primary care optometry?

Yes

True or False:

Initial management of strabismus and amblyopia can be performed in a primary care setting

true