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Management of paralytic squint

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Diagnosis and treatment of the underlying cause of paralytic squint is essential. A full medical examination should be instigated to exclude diseases such as hypertension and diabetes, and a neurological investigation to exclude intracranial lesions.

Non-traumatic lesions often resolve spontaneously or after treatment of the underlying condition. Progress may be monitored on sequential Hess charts which record the separation of images in all positions of gaze.

This may take months. During this period, double vision may be relieved by:

  • spectacle prisms - to minimise the amount of secondary muscle contracture
  • supervised patching
  • muscle surgery if the paralytic squint shows no sign of spontaneous improvement after 6 months

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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