Strabismus in Systemic Disease



Systemic disease can affect ocular motility due to involvement of the nerves, muscles, neuromuscular junction or orbital space. This chapter describes two systemic disorders that commonly result in strabismus with their associated clinical features, investigation modalities and treatment.


Myasthenia Thyroid Graves Immunosuppression Cogan 

Supplementary material

Video 10.1

A 55 year old man with bilateral ptosis, left more advanced than right, chin elevation and global reduction of eye movements. Following the application of an ice pack for 10 s there is an immediate improvement in both the lid position as well as the ocular motility (MOV 53308 kb)

Video 10.3

A 65 year old lady with bilateral proptosis and right lid retraction, secondary to thyroid eye disease. There is bilateral limitation of upgaze due to IR fibrosis, more pronounced ion the right eye (MOV 98553 kb)

Video 10.6

A 75 year old woman with bilateral ptosis and no manifest strabismus in primary gaze as evidenced by no movement on a cover-uncover test. However, she has significant limitation of eye movements in depression, dextroversion and laevoversion (MOV 72164 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Royal Free London NHS Foundation TrustLondonUK

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