Strabismus — Types and Management

A 35-year-old woman with sudden-onset horizontal diplopia and rightward gaze limitation is found to have esotropia that increases when looking to the right. A 9-year-old boy with lifelong inward deviation of the left eye has a constant esotropia of 25 prism diopters in all gazes. Which clinical finding best distinguishes the paralytic strabismus in the woman from the concomitant strabismus in the boy?

A 3-year-old child is brought to the ophthalmology clinic by his mother with a complaint of inward turning of the right eye. On examination, the child has a 25-prism diopter esotropia with normal ocular motility and clear media. What is the most common type of strabismus in children?

A 6-year-old girl presents with a 15-prism diopter exodeviation that is present intermittently, worse when she is fatigued or looking at distant objects. The deviation is not present at near. What is the most common type of exotropia in children?

A 3-year-old boy is brought to the pediatric ophthalmology clinic by his mother with a complaint of inward turning of the left eye. The child was born full-term without any perinatal complications. On examination, the left eye is turned inward (esotropia). The cover test reveals that when the right eye is covered, the left eye moves outward to fixate, and when the left eye is covered, the right eye moves inward to take up fixation. The child has full extraocular movements bilaterally. Cycloplegic refraction shows +2.50 D sphere in both eyes. What is the most likely diagnosis?

A 6-year-old girl is referred to the strabismus clinic with a 2-month history of sudden-onset left eye inward deviation. The mother reports that the child was playing with her siblings when she suddenly complained of double vision and the left eye turned inward. On examination, the left eye is deviated inward (esotropia) with restricted abduction. The right eye abducts normally. Pupillary reactions are normal and symmetric. Cycloplegic refraction shows no significant refractive error (−0.25 D OU). The child has no history of head trauma or recent illness. What is the most likely diagnosis?