Deviations in the position of the eye may be primary as well as secondary. Diagnoses with regards to primary deviations of the eye’s position are mostly made in children. Secondary deviations in position may happen at any age. It should be noted that the causes for those deviations are often different in children compared with those observed in adults. Again the same applies: the questions that you ask during the history-taking are based on the prediagnosis.
Prediagnosis
Congenital/connate causes
Infection / Inflammation
Developmental disorders
Degenerative disorders
Malignancies
Vascular problems
Trauma
Obstruction
When parents claim that their child’s eyes are not (always) positioned straight, the following questions are important:
- What is exactly noticeable regarding the eyes?
- When was this first noticed?
- Is it present continuously or intermittently?
- Is it always just as severe/obvious?
- Is the child’s eyesight affected?
- Which eye has a squint and is it always the same eye?
- Is there a family history of squint?
- Was the child born prematurely?
- Does the child have a brain abnormality or has this ever been suspected?
- Did the pregnancy occur without incidents?
- Did the mother have an infectious disease during the first trimester of pregnancy, which could have been responsible for the damage to the eye?
- Was the childbirth without incidents?
- Did the child have a lack of oxygen either during or shortly after birth?
- Was there ever skull trauma or eye globe/eye socket trauma?