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Diagnostic Tools in the Evaluation of Strabismus Secondary to Trauma

Correspondence: Requests for reprints should be addressed to: Karl J. Henson, C.O., Pediatric Eye Specialists, 1325 Pennsylvania Ave., Suite 110, Fort Worth, TX 76104.

Traumatic strabismus presents the examiner with several unique challenges. The patient’s signs and symptoms can vary widely from the quite dramatic to the very subtle. Symptoms may also vary from day to day. Injury sustained during head trauma can result in strabismus from neurologic causes, mechanical causes, or both. There are many questions to be answered in the motor exam of the patient with traumatic strabismus. Nerve damage can occur at any point along the pathway, peripherally or centrally. Mechanical causes include entrapment or disinsertion of the muscle from the globe. Throughout the exam, the investigator is aware that the differentiation between mechanical causes and neurologic involvement is one of the most important distinctions to make. This paper focuses on methods of identifying the key aspects and quantifying the strabismus associated with trauma.

Key words: strabismus, traumatic, sensory testing, motor testing, diplopia