Decompensated Strabismus in Adults

Abstract

The onset of strabismus in the adult patient, if not the result of documented trauma, may be the harbinger of serious systemic disease. Certain findings, however, may indicate decompensation of a long-standing deviation, and recognition of these findings may eliminate the urgency of costly and extensive medical testing. Examination of photographs to establish the presence of a previously-existing strabismus or anomalous head position, excessively large fusional amplitudes, the absence of diplopia or subjective cyclotorsion, spread of comitance and facial asymmetry all indicate that the strabismus is not acute, but rather the result of decompensation of a formerly well-controlled motor fusional mechanism.

In an era when exorbitant medical costs and the inadequacy of personal medical insurance coverage have become important national concerns, it may be prudent to re-consider the necessity of expensive testing when evidence exists to corroborate the long-standing nature of apparent adult-onset strabismus.

• strabismus
• diplopia
• decompensated strabismus