Which sign indicates possible strabismus when both eyes are open?

Which sign indicates possible strabismus when both eyes are open?

• A. Eyes do not look in the same direction at the same time
• B. Diplopia with reading
• C. Pupillary dilation in light
• D. Eyelid droop

Answer: (D)

Strabismus is when the eyes don’t align on a target because the eye muscles or their nerve supply aren’t working together. When you’re watching both eyes open, a droopy eyelid on one side can be a helpful clue because it often accompanies ocular motor nerve or muscle involvement that can also lead to the eye drifting. A ptotic eyelid signals that there may be a broader problem with eye control, which is why you’d notice misalignment or the eye not tracking with the other eye. Diplopia can occur, but it relies on the patient noticing and reporting double vision, which isn’t always present or reported, especially in children. Pupillary changes aren’t a typical sign of strabismus. So, a visibly droopy eyelid is a practical sign that prompts you to inspect for possible eye misalignment when both eyes are open.

Strabismus is when the eyes don’t align on a target because the eye muscles or their nerve supply aren’t working together. When you’re watching both eyes open, a droopy eyelid on one side can be a helpful clue because it often accompanies ocular motor nerve or muscle involvement that can also lead to the eye drifting. A ptotic eyelid signals that there may be a broader problem with eye control, which is why you’d notice misalignment or the eye not tracking with the other eye. Diplopia can occur, but it relies on the patient noticing and reporting double vision, which isn’t always present or reported, especially in children. Pupillary changes aren’t a typical sign of strabismus. So, a visibly droopy eyelid is a practical sign that prompts you to inspect for possible eye misalignment when both eyes are open.