Paralytic Squint


What is Paralytic squint?

Inability of the eye muscles to move the eye due to muscle paralysis.


Paralytic Squint Symptoms

  • Double vision which is compensated by the patient by closing the eyelid of the paralysed eye or by turning the head in order to position the eye better.
  • Vertigo/Giddiness

Paralytic Squint Causes

  • Trauma
  • Diabetes
  • Hypertension
  • Stroke
  • Demyelinating disease
  • Brain tumours

Paralytic Squint Risk Factors

  • Old age
  • Metabolic disorders like Diabetes, Hypertension and elevated cholesterol levels
  • Hereditary-family history of Demyelinating diseases; Myasthenia

Paralytic Squint Prevention

  • Healthy lifestyle
  • Metabolic control
  • Periodic eye and general health evaluation

Paralytic Squint Signs

  • Strabismus/squint
  • Limitation of eye movement
  • Compensatory head posture
  • False orientation


Paralytic Squint Diagnosis

  • Assessment of vision in each eye 
  • Assessment of angle of squint for distance , near and side gazes using prism
  • Assessment of eye movements
  • Double vision charting using Hess chart
  • Visual field testing
  • Color vision testing
  • Assessment of muscle strength by special tests
  • Complete eye evaluation


Paralytic Squint Treatment

  • Prism glasses 
  • Botox injection
  • Eye muscle surgery to relieve double vision and improve eye movement


Paralytic Squint Complications

  • Intractable double vision especially in adults interfering with daily activities
  • Neck strain due to abnormal head posture
  • Persistent giddiness/dizziness
  • False orientation

Written by: Dr. Manjula Jayakumar – Sr. Consultant Ophthalmologist, TTK Road


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