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Children with strabismus should be referred to an ophthalmologist.
If an acute cranial nerve palsy is suspected, referral to a pediatric
neurologist and brain imaging may be indicated.
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What Shouldn’t
Be Missed
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Third, fourth, and sixth cranial nerve
palsies may initially present with strabismus. Although some causes of these palsies
are benign or self-limited, they may be due to central nervous system
infections, tumors, or other serious diseases.
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- 1. Accommodative esotropia. Accommodative
esotropia is a form of eye crossing due to farsightedness. The majority
of children in the first several years of life are farsighted. Few
young children need to wear glasses, however, because the lens is
able to change its shape to focus (accommodation), as if the children have
a built-in pair of glasses. When children are more farsighted than
normal, the effort to focus is greater, and this effort may induce
esotropia. The esotropia usually resolves when the farsightedness
is corrected with spectacles. Bifocal glasses are sometimes used
if the eye crossing is worse when viewing near ...