management of paralytic squint
Last reviewed 01/2018
Diagnosis and treatment of the underlying cause of paralytic squint is essential. A full medical examination should be instigated to exclude diseases such as hypertension and diabetes, and a neurological investigation to exclude intracranial lesions.
Non-traumatic lesions often resolve spontaneously or after treatment of the underlying condition. Progress may be monitored on sequential Hess charts which record the separation of images in all positions of gaze.
This may take months. During this period, double vision may be relieved by:
- spectacle prisms - to minimise the amount of secondary muscle contracture
- supervised patching
- muscle surgery if the paralytic squint shows no sign of spontaneous improvement after 6 months