Keywords: visual impairment, strabismus, refractive error, cycloplegic refraction, Childhood Blindness

Background & objective: Strabismus is a misalignment of the eyes which can affect one or both eyes. It usually starts in early childhood, and it impacts on vision-related quality of life. Various factors have been described as to be leading to the development of strabismus in early childhood. The aim of this study was to present the rate and determinants of strabismus in children less than 12 years of age, attending our pediatric ophthalmology clinic of a hospital in central Saudi Arabia.

Methodology: It was a clinical-based prospective cross-sectional study of strabismus cases presented to a pediatric ophthalmology clinic in 2021. The incidence, demographic profile, indications for presentation, types of strabismus, angle, risk factors, association with refractive errors, amblyopia, and anisometropia, were reviewed. Descrtiptive statistics were used to present the study findings.

Results: Of the 300 children presenting to the pediatric ophthalmology unit, 154 (51.3%) were diagnosed with strabismus. Most of them (134; 87%) attended for vision impairment and cosmetic correction. Only 57 (37%) had been seen by the qualified ophthalmologists in the past. Esotropia (97; 63%) and Exotropia (40; 35.1%) were the main types of strabismus. Amblyopia was found in 25 (16.2%) children but was not significantly associated with esotropia or exotropia. (P = 0.6). The proposed mode of management included spectacles (70; 52.2%), patching (8; 6.0%), Botulin toxin injection (5; 3.7%), surgery (3; 2.2%), and monitoring strabismus angle (27; 17.9%).    

Conclusions: Esotropia was the most common type of strabismus. The high incidence of amblyopia and the fact that many were not seen before by qualified ophthalmologists suggested an urgent need for a system for screening children for vision and strabismus and a referral protocol from secondary to tertiary care units in the study area.

Abbreviations: UCVA: uncorrected visual acuity,  PVA: presented visual acuity,

Keywords: Childhood Blindness; cycloplegic refraction; refractive error; strabismus; visual impairment

Citation: AlHarkan DH. The magnitude and determinants of strabismus, among children under twelve years old, at a pediatric ophthalmology unit of a tertiary hospital in central Saudi Arabia. Anaesth. pain intensive care 2025;29(4):371-77. DOI: 10.35975/apic.v29i4.2822

Received: April 10, 2025; Revised: May 09, 2025; Accepted: May 09, 2025