Skip to main content
SpringerLink
Log in

Epidemiology of Pediatric Strabismus

  • Chapter
Book cover Pediatric Ophthalmology, Neuro-Ophthalmology, Genetics

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

Core Messages

  • Recognition and diagnosis of the individual forms of childhood strabismus are important for the best preservation of visual function.

  • Esotropia is the most common form of pediatric ocular deviation in the West, whereas exotropia predominates in the East.

  • Accommodative esotropia is the most prevalent form of strabismus in the West, comprising half of all esodeviations.

  • Congenital, or infantile, esotropia accounts for less than 10% of all pediatric esotropia, a figure much smaller than once widely believed.

  • Intermittent exotropia is the second most common form of childhood strabismus in the West and the most commonly diagnosed form of exodeviation worldwide.

  • Hyperdeviations are uncommon, with fourth cranial nerve palsy being the most prevalent etiology.

  • Major independent risk factors associated with strabismus development include: prematurity, central nervous system (CNS) impairment, low birth weight, family history, and refractive error.

  • Recent studies have reported a decline in the number of surgeries performed for strabismus; however, population-based data of congenital esotropia in the United States confirms a more stable rate.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mohney BG (2007) Common forms of childhood strabismus in an incidence cohort. Am J Ophthalmol 144:465–467

    Article  PubMed  Google Scholar 

  2. Yu CB, Fan DS, Wong V W, et al (2002) Changing patterns of strabismus: a decade of experience in Hong Kong. Br J Ophthalmol 86:854–856

    Article  PubMed  CAS  Google Scholar 

  3. Greenberg, AE, Mohney BG, Diehl NN, et al (2007) Incidence and types of childhood esotropia: a population-based study. Ophthalmology 114:170–174

    Article  PubMed  Google Scholar 

  4. Mohney BG, Greenberg AE, Diehl NN (2007) Age at strabismus diagnosis in an incidence cohort of children. Am J Ophthalmol 144:467–469

    Article  PubMed  Google Scholar 

  5. Greenberg AE, Mohney BG, Diehl NN (2007) Prevalence of amblyopia in an incidence cohort of childhood strabismus. In: Transactions of the 31st meeting of the european strabismological association. Editor: Rosario Gomez de Liano. European Strabismological Association. DP- M-8797-2008. Madrid. Spain. Pg 51–54

    Google Scholar 

  6. Pediatric eye disease investigator group (2002) Spontaneous resolution of early-onset esotropia: experience of the Congenital Esotropia Observational Study. Am J Ophthalmol 133(1):109–118

    Article  Google Scholar 

  7. Louwagie CR, Diehl NN, Greenberg AE, Mohney BG, et al (2009) Is the incidence of congenital esotropia declining? A population-based study from Olmsted County, Minnesota, 1965–1994. Arch Ophthalomol 127:200–203

    Article  Google Scholar 

  8. Mohney BG (2001) Acquired nonaccommodative esotro-pia in childhood. JAAPOS 5(2):85–89

    CAS  Google Scholar 

  9. Govindan M, Mohney BG, Diehl NN, et al (2005) Incidence and types of childhood exotropia: a population-based study. Ophthalmology 112:1046–108

    Article  Google Scholar 

  10. Nusz KJ, Mohney BG, Diehl NN (2005) Female predominance in intermittent exotropia. Am J Ophthalmol 140:546–547

    Article  PubMed  Google Scholar 

  11. Hunter DG, Ellis FJ (1999) Prevalence of systemic and ocular disease in infantile exotropia: comparison with infantile esotropia. Ophthalmology 106:1951–1956

    Article  PubMed  CAS  Google Scholar 

  12. Mohney BG, Huffaker RK (2003) Common forms of childhood exotropia. Ophthalmology 110:2093–2096

    Article  PubMed  Google Scholar 

  13. Havertape SA, Cruz OA, Chu FC (2001) Sensory strabismus — eso or exo? J Pediatr Ophthalmol Strabismus 38:327–330

    PubMed  CAS  Google Scholar 

  14. Tollefson, MM, Mohney BG, Diehl NN, et al (2006) Incidence and types of childhood hypertropia: a population-based study. Ophthalmology 113:1142–1145

    Article  PubMed  Google Scholar 

  15. Chew E, Remaley NA, Tamboli A, et al (1994) Risk factors for esotropia and exotropia. Arch Ophthalmol 112:1349–1354

    Article  PubMed  CAS  Google Scholar 

  16. Hakim RB, Tielsch JM (1992) Maternal cigarette smoking during pregnancy: a risk factor for childhood strabismus. Arch Ophthalmol 110:1459–1462

    Article  PubMed  CAS  Google Scholar 

  17. Holmstrom G, Rydberg A, Larsson E (2006) Prevalence and development of strabismus in 10-year-old premature children: a population-based study. J Pediatr Ophthalmol Strabismus 43:346–352

    PubMed  Google Scholar 

  18. Mohney BG, Erie JC, Hodge DO, et al (1998) Congenital esotropia in Olmsted County, Minnesota. Ophthalmology 105:846–850

    Article  PubMed  CAS  Google Scholar 

  19. Pennefather PM, Clarke M P, Strong N P, et al (1999) Risk factors for strabismus in children born before 32 weeks' gestation. Br J Ophthalmol 83:514–518

    Article  PubMed  CAS  Google Scholar 

  20. Robaei D, Rose KA, Kifley A, et al (2006) Factors associated with childhood strabismus: findings from a population-based study. Ophthalmology 113:1146–1153

    Article  PubMed  Google Scholar 

  21. Arora A, Williams B, Arora AK, et al (2005) Decreasing strabismus surgery. Br J Ophthalmol 89:409–412

    Article  PubMed  CAS  Google Scholar 

  22. Carney C V, Lysons DA, Tapley JV (1995) Is the incidence of constant esotropia in childhood reducing? Eye 9(Suppl):40–41

    PubMed  Google Scholar 

  23. Ferguson JA, Goldacre MJ, Henderson J, et al (1991) Ophthalmology in the Oxford region: analysis of time trends from linked statistics. Eye 5(Pt 3):379–384

    Article  PubMed  Google Scholar 

  24. MacEwen CJ, Chakrabarti HS (2004) Why is squint surgery in children in decline? Br J Ophthalmol 88:509–511

    Article  PubMed  CAS  Google Scholar 

  25. Matuso T, Matsuo C, Matsuoka H, et al (2007) Detection of strabismus and amblyopia in 1.5- and 3-year-old children by a preschool vision-screening program in Japan. Acta Med Okayama 61(1):9–16

    Google Scholar 

  26. O'Connor AR, Stephenson TJ, Johnson A, et al (2002) Strabismus in children of birth weight less than 1701 g. Arch Ophthalmol 120:767–773

    Article  PubMed  Google Scholar 

  27. Multi-ethnic pediatric eye disease study group (2008) Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months. Ophthalmology 115:1229–1236

    Article  Google Scholar 

  28. Lambert SR (2002) Are there more exotropes than eso-tropes in Hong Kong? Br J Ophthalmol 86:835–836

    Article  PubMed  CAS  Google Scholar 

  29. Beauchamp GR, Black BC, Coats DK, et al (2003) The management of strabismus in adults — I. clinical characteristics and treatment. J AAPOS 7:233–240

    Article  PubMed  Google Scholar 

  30. Magramm I, Schlossman A (1991) Strabismus in patients over the age of 60 years. J Pediatr Ophthalmol Strabismus 28:28–31

    PubMed  CAS  Google Scholar 

  31. Drover JR, Kean PG, Courage ML, et al (2008) Prevalence of amblyopia and other vision disorders in young Newfoundland and Labrador children. Can J Ophthalmol 43:89–94

    Article  PubMed  Google Scholar 

  32. Kornder LD, Nursey JN, Pratt-Johnson AJ, et al (1974) Detection of manifest strabismus in young children 1. A prospective study. Am J Ophthalmol 77:207–210

    PubMed  CAS  Google Scholar 

  33. Kornder LD, Nursey JN, Pratt-Johnson AJ, et al (1974) Detection of manifest strabismus in young children 2. A retrospective study. Am J Ophthalmol 77:211–214

    PubMed  CAS  Google Scholar 

  34. Fischbach LA, Lee DA, Englehardt RF, et al (1993) The prevalence of ocular disorders among Hispanic and Caucasian children screened by the UCLA mobile eye clinic. J Community Health 18(4):201–211

    Article  PubMed  CAS  Google Scholar 

  35. Voo I, Lee DA, Oelrich FO (1998) Prevalences of ocular conditions among Hispanic, white, Asian, and black immigrant students examined by the UCLA mobile eye clinic. J Am Optom Assoc 69:255–261

    PubMed  CAS  Google Scholar 

  36. Ohlsson, J, Villarreal G, Sjostrom A, et al (2003) Visual acuity, amblyopia, and ocular pathology in 12- to 13-year-old children in northern Mexico. J AAPOS 7:47–53

    Article  PubMed  Google Scholar 

  37. Juarez-Munoz, IE, Rodriguez-Godoy ME, Guadarrama-Sotelo ME, et al (1996) Frecuencia de trastornos of almo-logicos comunes en poblacion preescolar de una delegacion de la Ciudad de Mexico. Salud Publica Mex 38:212–216

    PubMed  CAS  Google Scholar 

  38. Graham PA (1974) Epidemiology of strabismus. Br J Ophthalmol 58:224–231

    Article  PubMed  CAS  Google Scholar 

  39. Stayte M, Johnson A, Wortham C (1990) Ocular and visual defects in a geographically defined population of 2-year-old children. Br J Ophthalmol 74:465–468

    Article  PubMed  CAS  Google Scholar 

  40. Williams C, Northstone K, Howard M, et al (2008) Prevalence and risk factors for common vision problems in children: data from the ALSPAC study. Br J Ophthalmol 92:959–964

    Article  PubMed  CAS  Google Scholar 

  41. Donnelly UM, Stewart NM, Hollinger M (2005) Prevalence and outcomes of childhood visual disorders. Ophthalmic Epidemiol 12:243–250

    Article  PubMed  Google Scholar 

  42. Frandsen AD (1960) Occurrence of squint: a clinical-statistical study on the prevalence of squint and associated signs in different groups and ages of the Danish population [dissertation] Acta Ophthalmol 62(Suppl):1

    Google Scholar 

  43. Nordlow W (1964) Squint — the frequency of onset at different ages, and the incidence of some associated defects in a Swedish population. Acta Ophthalmol (Copenh). 42:1015–1037

    Article  Google Scholar 

  44. Ohlsson J, Villarreal G, Sjostrom A, et al (2001) Visual acuity, residual amblyopia and ocular pathology in a screened population of 12–13-year-old children in Sweden. Acta Ophthalmol Scand 79:589–595

    Article  PubMed  CAS  Google Scholar 

  45. Kvarnstrom G, Jakobsson P, Lennerstrand G (2001) Visual screening of Swedish children: an opthalmological evaluation. Acta Ophthalmol Scand 79:240–244

    Article  PubMed  CAS  Google Scholar 

  46. Gronlund MA, Andersson S, Aring E, et al (2006) Ophthalmological findings in a sample of Swedish children aged 4–15 years. Acta Ophthalmol Scand 84:169–176

    Article  PubMed  Google Scholar 

  47. Karlica D, Galetovic D, Znaor L, et al (2008) Strabismus incidence in infants born in Split-Dalmatia county 2002– 2005. Acta Clin Croat 47:5–8

    PubMed  Google Scholar 

  48. Robaei D, Kifley A, Mitchell P (2006) Factors associated with a previous diagnosis of strabismus in a population-based sample of 12-year-old Australian children. Am J Ophthalmol 142:1085–1087

    Article  PubMed  Google Scholar 

  49. Teoh GH, Yow CS (1982) Prevalence of squints and visual defects in Malaysian primary one school children. Med J Malaysia 37(4):336–337

    PubMed  CAS  Google Scholar 

  50. Goh P-P, Abqariyah Y, Pokharel G P, et al (2005) Refractive error and visual impairment in school-age children in Gombak district, Malaysia. Ophthalmology 112:678–685

    Article  PubMed  Google Scholar 

  51. He M, Zeng J, Liu Y, et al (2004) Refractive error and visual impairment in urban children in southern China. Invest Ophthalmol Vis Sci 45:793–799

    Article  PubMed  Google Scholar 

  52. Lu, P, Chen X, Zhang W, et al (2008) Prevalence of ocular disease in Tibetan primary school children. Can J Ophthalmol 43:95–99

    Article  PubMed  Google Scholar 

  53. Matsuo T, Matsuo C (2005) The prevalence of strabismus and amblyopia in Japanese elementary school children. Ophthalmic Epidemiology 12:31–36

    Article  PubMed  Google Scholar 

  54. Matsuo T, Matsuo C (2007) Comparison of prevalence rates of strabismus and amblyopia in Japanese elementary school children between the years 2003 and 2005. Acta Med Okayama 61(6):329–334

    PubMed  Google Scholar 

  55. See L-C, Song H-S, Ku W-C, et al (1996) Neglect of childhood strabismus: Keelung Ann-Lo community ocular survey 1993–1995. Chang Gung Med J 19:217–224

    CAS  Google Scholar 

  56. Tengtrisorn S, Singha P, Chuprapawan C (2005) Prevalence of abnormal vision in one-year-old Thai children, based on a prospective cohort study of Thai children. J Med Assoc Thai 88(Suppl 9):S114–S120

    PubMed  Google Scholar 

  57. Murthy GVS, Gupta SK, Ellwein LB, et al (2002) Refractive error in children in an urban population in New Delhi. Invest Ophthalmol Vis Sci 43:623–631

    PubMed  CAS  Google Scholar 

  58. Nirmalan PK, Vijayalakshmi P, Sheeladevi S, et al (2003) The Kariapatti pediatric eye evaluation project: baseline ophthalmic data of children aged 15 years or younger in southern India. Am J Ophthalmol 136:703–709

    Article  PubMed  Google Scholar 

  59. Nepal B P, Koirala S, Adhikary S, et al (2003) Ocular morbidity in schoolchildren in Kathmandu. Br J Ophthalmol 87:531–534

    Article  PubMed  CAS  Google Scholar 

  60. Shrestha RK, Joshi MR, Ghising R, et al (2006) Ocular morbidity among children studying in private schools of Kathmandu valley: a prospective cross sectional study. Nepal Medical College Journal 8(1):43–46

    PubMed  Google Scholar 

  61. Friedman Z, Neumann E, Hyams S W, et al (1980) Ophthalmic screening of 38,000 children, age 1 to 2 ½ years, in child welfare clinics. J Pediatr Ophthalmol Strabismus 17:261–267

    PubMed  CAS  Google Scholar 

  62. Lithander J (1998) Prevalence of amblyopia with ani-sometropia or strabismus among schoolchildren in the Sultanate of Oman. Acta Ophthalmol Scand 76:658–662

    Article  PubMed  CAS  Google Scholar 

  63. Khandekar RB, Abdu-Helmi S (2004) Magnitude and determinants of refractive error in Omani school children. Saudi Med J 25(10):1388–1393

    PubMed  Google Scholar 

  64. Ebana Mvogo C, Bella-Hiag AI, Epesse E (1996) Le strabisme au Cameroun. J Fr Ophtalmol 19:705–709

    Google Scholar 

  65. Ajaiyeoba AI, Isawumi MA, Adeoye AO, et al (2007) Pattern of eye diseases and visual impairment among students in southwestern Nigeria. Int Ophthalmol 27:287–292

    Article  PubMed  Google Scholar 

  66. Ntim-Amponsah CT, Ofosu-Amaah S (2007) Prevalence of refractive error and other eye diseases in schoolchildren in the greater Accra region of Ghana. J Pediatr Ophthalmol Strabismus 44:294–297

    PubMed  CAS  Google Scholar 

  67. Wedner SH, Ross DA, Balira R, et al (2000) Prevalence of eye diseases in primary school children in a rural area of Tanzania. Br J Ophthalmol 84:1291–1297

    Article  PubMed  CAS  Google Scholar 

  68. Auzemery A, Andriamanamihaja R, Boisier P (1995) Enquete sur la prevalence et les causes des affections oculaires chez les enfants des ecoles primaries d'Antananarivo. Cahiers Sante 5:163–166

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA

    Amy E. Green-Simms & Brian G. Mohney

Authors
  1. Amy E. Green-Simms
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian G. Mohney
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Justus-Liebig-University UKGM GmbH Giessen Campus, Friedrichstraße 18, Giessen, 35392, Germany

    Birgit Lorenz (Professor of Ophthalmology) (Professor of Ophthalmology)

  2. Department of Ophthalmology, Professor of Ophthalmology and Neurology Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Michael C. Brodsky

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Green-Simms, A.E., Mohney, B.G. (2010). Epidemiology of Pediatric Strabismus. In: Lorenz, B., Brodsky, M.C. (eds) Pediatric Ophthalmology, Neuro-Ophthalmology, Genetics. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85851-5_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-85851-5_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-85850-8

  • Online ISBN: 978-3-540-85851-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation