Examining a Patient with Strabismus



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.


Cover test Snellens Diplopia Ocular motility Ductions Versions 

Supplementary material

Video 4.8

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)

Video 4.10b

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)

Video 4.11

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)

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Royal Free London NHS Foundation TrustLondonUK

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