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13.13

Strabismus (SQUINT)

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 13, Ophthalmic Conditions.

Clinical Description

Misalignment of the eyes

  • Types
  • Esotropia: eye rotated so that cornea is turned nasally
  • Exotropia: eye rotated so that cornea is turned temporally
  • Hypotropia: eye rotated so that cornea is turned downwards

Signs and Symptoms

  • Eye strain
  • Double vision

Investigations

  • Misalignment seen on corneal light reflex and cover tests

Treatment

  • Depends on the type of strabismus and the underlying cause
  • Non-surgical: refractive error correction or use of prisms
  • Surgical: strabismus surgery
  • amblyopia treatment such as patching, in children

Complications

  • Amblyopia (in children), double vision

Complications and Referral Criteria

  • Refer ALL cases

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