Strabismus in a 5-year-old child?

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Last updated: February 13, 2025View editorial policy

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Differential Diagnosis for 5 Year Old with Eye Crossing

  • Single Most Likely Diagnosis
    • Esotropia (accommodative or non-accommodative): This is the most common cause of eye crossing in children, often due to refractive errors or muscle imbalances.
  • Other Likely Diagnoses
    • Exotropia: Although less common than esotropia, exotropia can also cause eye misalignment and is often associated with refractive errors or muscle imbalances.
    • Convergence insufficiency: A condition where the eyes have difficulty converging, leading to eye strain and misalignment.
    • Amblyopia: A condition where one eye has reduced vision, which can lead to eye misalignment and crossing.
  • Do Not Miss Diagnoses
    • Cranial nerve palsy (III, IV, or VI): Although rare, cranial nerve palsies can cause eye misalignment and crossing, and can be a sign of a serious underlying condition such as a brain tumor or stroke.
    • Orbital or intracranial tumor: Tumors in the orbit or brain can cause eye misalignment and crossing, and can be life-threatening if not diagnosed promptly.
    • Thyroid eye disease: A condition where the thyroid gland produces excess hormones, leading to eye bulging and misalignment.
  • Rare Diagnoses
    • Moebius syndrome: A rare congenital condition characterized by facial paralysis and eye misalignment.
    • Duane syndrome: A rare congenital condition characterized by limited eye movement and misalignment.
    • Congenital fibrosis of the extraocular muscles: A rare condition where the eye muscles are abnormal, leading to eye misalignment and limited movement.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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