Strabisme chez l'enfant

Strabismus is a highly plural and many-sided pathology. The classification of such diseases is very difficult due to the intricacy of clinical signs and pathophysiological mechanisms. The prognosis of strabismus is correlated to the age of onset, due to the influence of visual experience on the development of vision. Examination by an ophthalmologist is mandatory in case of strabismus evidence or strabismus suspicion. Strabismus may reveal an organic ocular disease, such as in the rare but fearsome case of retinoblastoma. By impairing vision, any strabismus can lead to an amblyopia, which can itself be responsible for strabismus in some cases. In early strabismus, monocular amblyopia can be cured, but binocular vision remains impaired; in late strabismus, the treatment must restore both monocular vision of each eye and binocular vision. Priorities must be defined in the treatment of strabismus; satisfactory visual function must be restored first. Optical correction is always essential, and in case of amblyopia, occlusion and optical or pharmacological penalizations may be considered. Most of the time, surgery for ocular deviation is considered only secondarily, after restoration of satisfactory sensorial status. Specialized management as early as possible is necessary in all cases, to improve functional results of the treatment.