Examining a Patient with Strabismus
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Examining a patient with strabismus requires a logical and structured approach. This includes obtaining a comprehensive history of the presenting complaints and associated symptoms as well as relevant medical and ocular history. Measurement of vision is crucial and the strabismus is then evaluated using a cover-uncover test. Ocular motility testing and diplopia charting can provide further valuable information.
KeywordsCover test Snellens Diplopia Ocular motility Ductions Versions
Cover test. A 70 year old man with a right large angle esotropia. On covering the left eye, he takes up fixation with the right but immediately switches back when the cover is removed suggesting this is a constant rather than an alternating form of strabismus (MOV 25886 kb)
A 24 year old woman with a well controlled exophoria. Initially there is no obvious strabismus but this decompensates on alternate cover test to an alternating exophoria (MOV 99539 kb)
A 64 year old woman with a left sixth nerve palsy, following a left MR recession. She has an esotropia in primary gaze and limitation of abduction bilaterally, left more than right (MOV 13932 kb)