Differential Diagnosis for a 2-Month-Old Child with Crossed Eyes
Single Most Likely Diagnosis
- Infantile Esotropia: This condition is a common cause of crossed eyes in infants, typically appearing between 1-6 months of age. It is characterized by an inward deviation of the eyes, which can be constant or intermittent.
Other Likely Diagnoses
- Accommodative Esotropia: Although less common in infants as young as 2 months, this condition can occur if there is a significant refractive error, leading to inward turning of the eyes as the child tries to focus.
- Pseudostrabismus: This condition gives the appearance of crossed eyes due to a wide nasal bridge or epicanthal folds, but the eyes are actually aligned properly when examined closely.
Do Not Miss Diagnoses
- Retinoblastoma: Although rare, this serious eye cancer can cause strabismus (crossed eyes) if it affects the vision significantly enough to disrupt eye alignment.
- Cataract: Congenital cataracts can cause visual deprivation, leading to strabismus or crossed eyes.
- Glaucoma: Infantile glaucoma can cause enlarged eyes and vision problems, potentially leading to strabismus.
Rare Diagnoses
- Duane Syndrome: A rare congenital disorder characterized by limited horizontal eye movement, which can cause the appearance of crossed eyes.
- Moebius Syndrome: A rare neurological disorder that can affect the nerves controlling eye movement, leading to crossed eyes among other symptoms.
- Congenital Cranial Nerve Palsies: Rare conditions where there is a weakness or paralysis of the nerves that control eye movement, potentially causing strabismus.