BACKGROUND Tumors that affect the visual system are a significant cause of liability claims involving eyecare practitioners. Individuals with brain tumors or intraocular tumors may seek examination for associated binocular vision disorders such as strabismus and reduced acuity. A disporportionate number of these individuals are children. METHODS A review of malpractice claims was performed to identify representative clinical presentations in which binocular vision disorders were the cause for examination. RESULTS Strabismus and amblyopia in children, if not promptly diagnosed and properly treated, can be the basis for a malpractice claim. Binocular vision disorders may also result from brain or intraocular tumors affecting children, and failure to timely detect the presence of these underlying diseases can also become the basis for a malpractice claim. CONCLUSIONS Eyecare practitioners should examine carefully children with binocular vision disorders to rule out the possibility of an associated brain or intraocular tumor. Key findings include decreased visual acuity, acute strabismus, and indications of neurological disease such as optic atrophy, papilledema, visual field loss, and problems with gait and coordination.