Value of orthoptics in pre-and post-surgical management of strabismus

Orthoptics as an aid to the diagnosis and assessment of a case of strabismus is of great value, and so it is in the evaluation of the result of treatment. But orthoptic treatment in the form of exercises, although important in certain cases, has its limitations, for instance it is useless unless the patient is old enough to be fully co-operative. Indeed if a child suffers from a non-paralytic convergent strabismus which started in earliest infancy and if the correct treatment is given at an early stage it will be too soon for any form of orthoptic exercise. In such circumstances the prevention and correction of amblyopia by means of occlusion and the full correction of refractive errors are the most important initially, to be followed by surgical treatment if indicated. The necessity for keeping a patient under observation for many years after treatment appears to be completed is emphasized, especially when amblyopia had to be overcome initially or when the function of binocular vision has been unstable. Examples of typical cases are shown.