Treatment of paralytic eye motility disorders

Paralytic strabismus is caused by paresis or paralysis of one or more extraocular muscles that are innervated by cranial nerve lll, IV and Vl. They are characterized by squinting angle that depends on the direction of the gaze and the fixating eye. Typically, the angle is greater in the field of affected muscle, and when the patient is fixing with the affected eye. While younger children in some cases can suppress double vision, older children and adults with acquired paralytic strabismus usually have diplopia, which they try to avoid by compensatory head posture. Some types of paralytic strabismus can be congenital but it is important to diagnose acquired paralytic strabismus that can be caused by some neurological or systemic disorders and requires further investigation. Treatment of the paralytic strabismus is challenging, and despite the multiple surgeries, results can be disappointing.