Strabismus in the primary care community

A common childhood disorder that we frequently see in our behavioural/developmental practice is strabismus (squint). Strabismus is a common disorder of ocular alignment that affects 2-4% of children.¹ Strabismus may affect older children and adults. Binocular vision is the use of both eyes simultaneously in such a manner that each retinal image contributes to the final percept.² If the eyes are misaligned, binocular vision will not exist.

Strabismus is a misalignment between the two eyes (the two eyes do not look at the same place at the same time). The brain receives two different images from the eyes which will lead to diplopia (double vision) and confusion. This creates havoc with the patient’s ability to trust what is seen and this will have a negative impact on their visual function. With time, the brain will adapt and learn to ignore the image from the deviated eye which will lead to sensory adaptations such as suppression and amblyopia.