Evaluating squints in children. 2013

Corina O'Dowd
GCELead, MBBS, LLB, BA, Hospital Medical Officer, Peninsula Health, VIictoria.

BACKGROUND Strabismus ('squint') is a common childhood disorder that can cause psychosocial distress and permanent functional disability. Early diagnosis is important to maximise visual rehabilitation and reduce the risk of amblyopia. There is currently no national Australian screening program for strabismus, which makes it important for all general practitioners (GPs) to master practical skills for evaluating this condition. GPs should also be aware of red flags in a history and examination that necessitate prompt investigation and management. OBJECTIVE This article reviews practical screening tests to identify childhood strabismus, and discusses a framework for timely intervention. CONCLUSIONS A comprehensive history is used to distinguish between primary and acquired strabismus. The four tests used to screen for stra-bismus are the light reflex test, the red reflex test, the cover test and the uncover test. Any child diagnosed with strabismus should be referred to an ophthalmologist for further assessment.

UI MeSH Term Description Entries
D008487 Medical History Taking Acquiring information from a patient on past medical conditions and treatments. Medical History, Previous,Past Medical History, Family,Previous Medical History,Family Health History,Family History, Health,Family History, Medical,Family Medical History,History Taking, Medical,Family Health Histories,Family Medical Histories,Health Family Histories,Health Family History,Health History, Family,History, Previous Medical,Medical Family Histories,Medical Family History,Medical Histories, Previous,Medical History, Family,Previous Medical Histories
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001315 Australia The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra. Canton and Enderbury Islands,Christmas Island,Christmas Island (Australia)
D013285 Strabismus Misalignment of the visual axes of the eyes. In comitant strabismus the degree of ocular misalignment does not vary with the direction of gaze. In noncomitant strabismus the degree of misalignment varies depending on direction of gaze or which eye is fixating on the target. (Miller, Walsh & Hoyt's Clinical Neuro-Ophthalmology, 4th ed, p641) Concomitant Strabismus,Dissociated Horizontal Deviation,Dissociated Vertical Deviation,Heterophoria,Heterotropias,Hypertropia,Non-Concomitant Strabismus,Nonconcomitant Strabismus,Phorias,Squint,Strabismus, Comitant,Strabismus, Noncomitant,Convergent Comitant Strabismus,Mechanical Strabismus,Comitant Strabismus,Comitant Strabismus, Convergent,Deviation, Dissociated Horizontal,Dissociated Horizontal Deviations,Dissociated Vertical Deviations,Heterophorias,Heterotropia,Horizontal Deviation, Dissociated,Hypertropias,Non Concomitant Strabismus,Noncomitant Strabismus,Phoria,Strabismus, Concomitant,Strabismus, Convergent Comitant,Strabismus, Mechanical,Strabismus, Non-Concomitant,Strabismus, Nonconcomitant
D014787 Vision Tests A series of tests used to assess various functions of the eyes. Test, Vision,Tests, Vision,Vision Test
D058006 General Practice Patient-based medical care provided across age and gender or specialty boundaries. Practice, General

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