Guidelines for the Management of Strabismus in Childhood

  • 16 Mar 2012
  • RCOphth

This guideline is designed for ophthalmologists managing children with strabismus (syn.squint), which is defined as a pathological misalignment of the visual axes. This is a broad subject and the reader is referred to comprehensive texts, for further information see bibliography (page 42).

The guidelines are intended to give general principles of management. It is assumed throughout this document that professionals dealing with common and uncommon cases of strabismus will have had adequate training and experience to manage children with these conditions. This document represents the current view of best practice endorsed by the College. Please also refer to the Royal College Quality standards document and Ophthalmic services for children. The management of strabismus in childhood is multidisciplinary matter and usually involves parents and children, ophthalmologists, orthoptists and optometrists.

General practitioners, health visitors, paediatricians and paediatric neurologists may also become involved in the management of children with strabismus. It is desirable that these parties are committed to locally agreed care pathways, covering visual screening, referral, assessment, treatment and the monitoring of progress of children identified with strabismus. The latter is particularly important, as it is common that information will change with development, and multiple follow up visits will be required. Written information about strabismus should be available. Adequate time should be made available by the clinicians involved, in order to explain the terminology, the possible treatments, what they involve and for the consenting procedures that are required for surgical intervention.