소아시기에 사시수술을 받은 후 재수술한 환자의 임상 분석

김연희,최미영,Youn Hui Kim,M,D,Mi Young Choi,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.6

Purpose: To report the clinical characteristics of patients undergoing reoperation after strabismus surgery during childhood. Methods: Sixty-one patients who had undergone strabismus surgery in childhood and later reoperation were included. Age, visual acuity, type of strabismus at the first and second operations and postoperative angle of deviation were analyzed. The causes of reoperation were classified into recurrent, consecutive, or newly developed strabismus. Recurrent strabismus was defined as strabismus developed in the same direction after correction within 10 prism diopters (PD). Consecutive strabismus was defined as strabismus developed in the opposite direction after surgical overcorrection. Results: The mean duration between the first operation and reoperation was 5.6 years. Recurrent exotropia was the most common cause of reoperation. The incidence of vertical strabismus was higher in reoperations than in first operations (4.9 vs 26.2%, P=0.020). Most incidences of vertical strabismus in the reoperation were newly developed after first operation for horizontal strabismus. At the last follow-up, 63.9% had ocular alignment within 10PD in the horizontal plane and within 8PD in the vertical plane. The frequency of amblyopia was 16.4%. Conclusions: Recurrent exotropia was the most common cause of reoperation for strabismus. The incidence of vertical strabismus was higher in reoperations than in first operations.

사시수술과 관련 없는 복시에 대한 프리즘안경의 치료 결과

황혜성,최미영 대한안과학회 2018 대한안과학회지 Vol.59 No.8

Purpose: To evaluate the therapeutic results of the patients wearing the prism glasses due to strabismus with diplopia unrelated to strabismus surgery. Methods: Between May 2002 and October 2016, this retrospective study evaluated medical records of 23 patients who were wearing prism glasses due to strabismus with diplopia unrelated to strabismus surgery. The patients failed to adjust to the prism glasses and stopped within 3 months were defined as the adaptation failure group. The patients wearing prism glasses for 3 months or more was defined as adaptation success group. In the prism adaptation success group, he patients who underwent strabismus surgery during follow up were defined as treatment failure. Data were collected the types and causes of strabismus, the deviation angle at starting treatment of prism glasses and last visits, best corrected visual acuity, Titmus stereo test and Worth 4 dot test. Results: Of the total 23 patients, 18 patients had horizontal strabismus, four patients had vertical strabismus and one had horizontal and vertical strabismus. The causes of strabismus were acute acquired comitant esotropia (12 patients), paralytic strabismus (9 patients), and thyroid associated ophthalmopathy (two patients). There was no significant changes in deviation angle as well as the prism diopter of prism glasses after prism glasses treatmet. The prism glasses-adaptation group was 70%, and 31% of them were performed strabismus surgery. There was no reduction in visual acuity in all patients. Among the prism glasses adaptation group, 33% of the prism glasses-adaptation group had poor binocular function. Conclusions: In the strabismus patients with diplopia unrelated to strabismus surgery 70% of the patients adapted prism glasses more than 3 months and 31% of them required strabismus surgery. Therefore, prism glasses treatment may be one of the non-surgical approaches in the strabismus patients with diplopia unrelated to strabismus surgery. 목적: 사시수술과 관련 없이 복시를 동반한 사시가 지속되어 프리즘안경을 착용한 환자들의 치료 결과에 대하여 알아보고자 하였다. 대상과 방법: 2002년 5월부터 2016년 10월 사이에 사시수술과 관련 없이 복시를 동반한 사시로 프리즘 안경을 착용한 환자 23명의 의무기록을 후향적으로 조사하였다. 3개월 이내에 프리즘안경을 포기한 경우를 프리즘안경 적응 실패군, 3개월 이상 프리즘안경을 착용한 경우를 프리즘안경 적응 성공군으로 정의하였고, 적응 성공군에서 경과관찰 중 추가적인 사시수술이 필요하지 않았던 경우를치료 성공, 사시수술을 시행한 경우를 치료 실패로 정의하였다. 사시의 종류와 원인, 프리즘안경 착용 시작과 마지막 내원 시의 편위각, 프리즘안경 도수, 최대교정시력, 티트무스검사, 워트4등검사를 분석하였다. 결과: 전체 23명 중 수평사시가 18명, 수직사시가 4명, 혼합사시가 1명이었다. 사시 원인은 급성후천일치내사시 12명, 마비사시 9명, 갑상샘눈병증 2명이었다. 프리즘안경 착용 시작과 평균 23개월 이후의 마지막 내원 시의 편위각과 프리즘안경 도수는 통계적으로 유의한 차이가 없었다. 23명 중 16명(70%)에서 프리즘안경 적응 성공군에 해당하였으며, 이 중 5명(31%)에서만 사시수술을 시행하였다. 모든 환자에서 시력이 저하된 경우는 없었으며, 프리즘안경 적응 성공군 중 양안시가 불량한 경우는 33%였다. 결론: 사시수술과 관련 없이 복시를 동반하는 사시의 70%에서 3개월 이상 프리즘안경 치료에 적응하였고, 이 중 31%에서만 사시수술이 필요하였다. 따라서 사시수술과 관련 없이 복시를 동반하는 사시에서 비수술적 치료의 한 방법으로 프리즘안경 치료를 고려할수 있다.

내시경적 안와감압술을 시행한 갑상샘눈병증 환자에서 술 후 발생한 사시에 영향을 미치는 요인

김지은(Ji Eun Kim),강성모(Sung Mo Kang) 대한안과학회 2021 대한안과학회지 Vol.62 No.6

목적: 내시경적 안와감압술을 시행한 갑상샘눈병증 환자에서 술 후 발생한 사시에 영향을 미치는 요인에 대해 알아보고자 하였다. 대상과 방법: 갑상샘눈병증을 진단받고 내시경을 이용한 안와감압술을 시행 받은 환자 중 술 후 사시가 발생한 환자 13명과 사시가 발생하지 않은 환자 22명, 총 35명을 대상으로 의무기록을 후향적으로 분석하였다. 안구돌출측정, 프리즘 사시검사 및 안와 컴퓨터단층촬영을 이용한 외안근의 면적을 측정하였으며, 갑상샘 자가혈청 항체검사를 시행하였다. 결과: 단변량 로지스틱 회귀분석 시 술 후 사시 환자군과 비사시 환자군에서 모든 외안근의 면적(p<0.050)에서 유의한 차이를 보였으며, 경계성의 유의한 요인(p<0.1)인 나이, 성별을 포함하여 다변량 로지스틱 회귀분석을 추가로 시행한 결과 술 후 사시 환자군에서 남성(β=-3.346, p=0.031)과 좌측 외직근의 면적(β=0.181, p=0.046)이 술 후 사시 발생에 영향을 주는 것으로 나타났다. 술 후 사시 환자군은 수평사시가 9명, 복합사시가 4명이었으며, 수평사시군에서 사시 각도는 좌측 내직근의 면적(r=0.749, p=0.020)과, 복합사시군에서 수직사시 각도는 좌측 하직근의 면적(r=0.949, p=0.048)과 유의한 양의 상관관계를 보였다. 결론: 안와감압술 후 사시 발생의 관련 요인으로는 성별과 외직근의 면적이 관련 있었으며, 특히 내직근과 하직근의 면적은 각각 수평 사시, 수직사시 각도와 양의 상관관계를 보였다. 이를 바탕으로 안와감압술 후 사시 발생의 예측 인자로 고려해볼 수 있을 것이다. Purpose: To identify the factors associated with postoperative strabismus by endoscopic orbital decompression in patients with thyroid-associated ophthalmopathy (TAO). Methods: This study was a retrospective chart review conducted using the data from 35 patients with TAO (13 with postoperative strabismus and 22 with postoperative non-strabismus) who underwent endoscopic orbital decompression. Hertel exophthalmometry, prism strabismus test, and thyroid-related autoantibody test were performed, and extraocular muscle (EOM) area was calculated using orbital computed tomography. Results: Univariate logistic regression analysis showed that all EOM areas were significantly different between the postoperative strabismus group and non-strabismus group (p < 0.05). Multivariate logistic regression analysis including borderline significant (p < 0.1) variables (age and sex) showed that male sex (β = -3.346, p = 0.031) and left lateral rectus area (β = 0.181, p = 0.046) were associated with postoperative strabismus. In the postoperative strabismus group, there were nine patients with horizontal strabismus and four patients with complex strabismus. In the horizontal strabismus group, the angle of strabismus was positively correlated with the left medial rectus (LMR) area (r = 0.749, p = 0.020). In the complex strabismus group, the vertical angle of strabismus was positively correlated with the left inferior rectus (LIR) area (r = 0.949, p = 0.048). Conclusions: Sex and lateral rectus muscle area were associated with postoperative strabismus by endoscopic orbital decompression in patients with TAO. The areas of LMR and LIR, in particular, were positively correlated with horizontal and vertical angles, respectively. These results could be considered predictive of strabismus after endoscopic orbital decompression.

사시가 동반된 갑상샘눈병증 환자군과 사시가 없는 갑상샘눈병증 환자군의 특징 비교

최경준,김승현,이주연 대한안과학회 2015 대한안과학회지 Vol.56 No.10

Purpose: To determine immunochemical and clinical differences in thyroid-associated ophthalmopathy (TAO) patients with restrictive strabismus and without strabismus. Methods: A retrospective chart review of 15 TAO patients with strabismus (25 eyes) and 24 TAO patients without strabismus (39 eyes) who presented to the Ophthalmology Clinic between August 2011 and December 2013 was performed. Visual acuity, intraocular pressure (IOP), Hertel exophthalmometry, soft tissue score, and enlargement of extraocular muscles on computed tomography (CT) were obtained and compared in each group. Thyroid related autoantibody (thyroid-stimulating hormone receptor antibody, TRAb; thyroid peroxidase antibody, TPOAb; anti-thyroglobulin antibody, TgAb) titers and positive rates were obtained at the time of diagnosis or before treatment and analyzed. Results: The gender and smoking proportion were not significantly different between the 2 groups. The mean age of TAO patients with strabismus was 52.53 years and of TAO patients without strabismus 40.33 years (p = 0.004). The differences in visual acuity and IOP between the 2 groups were not significant. Hertel exophthalmometry showed less proptotis in the TAO with strabismus group than the TAO without strabismus group (16.84 mm versus 18.67 mm). The soft tissue score was not significantly different. The extraocular muscle enlargement rate of TAO with strabismus was significantly higher than in TAO without strabismus group. In the TAO with strabismus group, TRAb level was higher than in the TAO without strabismus group (p = 0.021). Conclusions: The TAO with strabismus group was older and had higher positive rate, level of TRAb, and extraocular muscle enlargement rate on CT than the TAO without strabismus group. Furthermore, proptosis was less definite in the TAO with strabismus group. 목적: 사시가 동반된 갑상샘눈병증 환자들이 사시가 없는 갑상샘눈병증 환자들과 비교하여 어떠한 혈청 자가항체와 안과 특징을 가지고 있는지 알아보고자 한다. 대상과 방법: 2011년 8월부터 2013년 12월까지 안과에 내원하여 갑상샘눈병증으로 진단 받은 환자 39명 중에 사시를 동반한 환자15명 25안과, 사시가 동반되지 않은 환자 24명 39안을 대상으로 후향적으로 의무기록을 분석하였다. 시력, 안압, Hertel 안구돌출계값, 연조직점수(soft tissue score), 전산화 단층촬영상 외안근의 비대 여부 등을 비교하였다. 첫 진단 시 또는 치료 시작 전 시행한갑상샘눈병증 관련 자가 혈청 항체 역가와 양성률을 비교하였다. 결과: 두 군 간에 성별, 흡연자의 비율은 유의한 차이가 없었다. 사시가 동반된 환자군 평균연령은 52.53세였고, 사시가 없는 환자군은40.33세로 전자의 경우가 더 높았다(p=0.004). 두 군 간 시력, 안압의 차이는 없었다. 사시가 동반된 갑상샘눈병증군에서 안구돌출이작은 것으로 나타났고(16.84 mm, 18.67 mm), 연조직점수는 유의한 차이가 없었다. 외안근의 비대 여부는 사시가 동반된 환자군에서높은 양성률을 보였다(p=0.000). 사시가 동반된 군에서 갑상샘자극호르몬 수용체 항체가 더 높은 항체 역가와 양성률을 보였다(역가=12.71, p=0.021). 결론: 갑상샘눈병증 환자 중 사시가 동반된 경우 연령이 더 높았고 갑상샘자극호르몬 수용체 항체의 역가와 양성률이 높았다. 그리고근육비대가 나타나는 비율이 더 높았고, 안구돌출 정도는 덜한 것으로 나타났다.

Case Report : Presence of Fusion in Albinism after Strabismus Surgery Augmented with Botulinum Toxin (Type A) Injection

( Sepideh Tavakolizadeh ),( Azadeh Farahi ) 대한안과학회 2013 Korean Journal of Ophthalmology Vol.27 No.4

It is commonly accepted that albino patients with strabismus rarely achieve binocularity and depth perception after strabismus surgery. The presence of retino-geniculo-cortical misrouting, a hallmark of the visual system in albinism, does not necessarily cause total loss of binocular vision, however, not even in albino patients with strabismus. Recently some degrees of stereopsis were reported in albinism patients with minimal clinical nystagmus, if any, in the absence of strabismus. It is possible that patients with albinism and strabismus have binocular visual potential which appears after strabismus correction and provides appropriate postoperative alignment in the long term. Here we present two cases of clinically diagnosed oculocutaneous albinism, an 18-year-old girl and a 16-year-old boy, both with exotropia ≥40 prism diopter, who gained acceptable alignment and fusion after surgical correction of their strabismus as demonstrated on Bagolini testing. In cases of albinism accompanied by visual pathway abnormalities and strabismus, binocular visual potential is not impossible, and some levels can be expected. Thus, these patients, like other cases of strabismus, may benefit from treatment of strabismus at an earlier age to achieve appropriate alignment, cosmetic satisfaction, and a possibly increased chance of fusion.

60세 이상 연령에서 사시수술을 받은 환자의 임상분석

이로운(Ro woon Yi),박신혜(Shin Hae Park),신선영(Sun Young Shin) 대한안과학회 2017 대한안과학회지 Vol.58 No.4

목적: 노인인구의 증가로 사시수술을 받는 고령환자가 증가하고 있다. 이에 사시수술을 받은 60세 이상의 고령환자의 임상양상에 대해 알아보고자 하였다. 대상과 방법: 2011년 1월부터 2015년 12월 사이 5년간 가톨릭대학교 서울성모병원 안센터에서 사시수술을 받은 환자들 중 60세 이상 환자를 대상으로 수술을 하게 된 이유, 원인질환, 사시의 임상양상, 수술 후 재발률, 수술관련 합병증 발생률, 수술 후 복시의 발생 비율을 조사하였다. 결과: 60세 이상 환자 98명 중 사시수술환자에서 사시수술을 하게 된 목적은 복시로 인한 불편감이 58.2%, 외모개선의 미용적 목적이 41.8%를 차지하였고, 사시의 양상은 내사시(40.8%)가 가장 높은 빈도를 차지하였으며 수평-수직 복합형 사시(29.6%)가 뒤를 이었다. 사시의 발병원인은 제한사시(31.6%)와 신경마비사시(30.6%)가 비슷한 빈도로 높게 나타났다. 수술 후 재발은 4.1%에서 확인되었고, 재수술률은 3.1%였다. 복시로 인한 불편감으로 사시수술을 한 후 수술 후에도 복시가 있었던 경우는 15.8%, 미용적 목적으로 수술한 후 수술 후에 복시가 발생한 경우는 4.9%에서 나타났다. 전안부허혈증후군이나 안구파열 등 심각한 안과적 합병증이 발생한 경우는 없었으며 전신마취로 수술을 받은 89명의 환자에서 마취관련 합병증은 발생하지 않았다. 결론: 60세 이상의 환자에서 사시 수술은 복시를 호전시키고 외형적 불만족을 교정하는 데 효과적이고 안전하였다. Purpose: In recent years, there has been an increase in the number of strabismus operations performed on patients aged 60 years and over. This study aims to establish the characteristics and outcomes of old age strabismus. Methods: Patients aged 60 years and over who underwent strabismus surgery between January 2011 and December 2015 were included in this study. The purpose of surgery, type of strabismus, etiology, postoperative recurrence, prevalence of general and ocular complications, and postoperative diplopia rate were reviewed. Results: Ninety-eight patients aged 60 years or older were identified, and 58.2% of patients had strabismus surgery to improve diplopia, while 41.8% chose surgery for cosmetic purposes. Esotropia was the most common type of strabismus found in 40.8% of the patients, and horizontal-vertical combined type was the second highest at 29.6%. The etiology of strabismus was similarly high in both the restrictive pattern (31.6%) and neuro-paralytic pattern (30.6%). The recurrence rate after strabismus surgery was 4.1%, and the reoperation rate was 3.1%. The remnant diplopia rate after surgery in patients with diplopia was 15.8%, and the diplopia occurring rate in patients who underwent surgery for cosmetic purposes was 4.9%. No severe ocular complications such as anterior segment syndrome or eyeball rupture occurred. Anesthesia related problems did not occur in any of the patients who underwent general anesthesia. Conclusions: Strabismus in patients aged 60 years and over is an effective and safe way to improve diplopia and cosmetic status by restoring ocular alignment.

단안 소아백내장과 사시발현의 임상양상

황성수(Sung Soo Hwang),이수정(Soo Jung Lee) 대한안과학회 2017 대한안과학회지 Vol.58 No.4

목적: 단안 소아백내장 환자들에서 사시의 유병률 및 임상양상과 발생에 영향을 미치는 인자들을 알아보고자 하였다. 대상과 방법: 1996년 1월부터 2011년 1월까지 단안 소아백내장으로 백내장 제거술을 시행 받은 환자 42명을 대상으로 수술 전과 수술 후에 각각 사시각 검사, 안구운동검사를 시행하여 사시 유병률을 확인하였으며 수술 전후 안구정렬에 따라 정위/정위, 정위/사시, 사시/사시로 나누어 세 군에서 수술시기, 시력, 약시유무, 구면렌즈대응치를 비교하였다. 결과: 소아백내장수술 전 사시는 7명에서 동반되어 있었고 수술 전에 사시가 없다가 수술 후 사시가 발생한 경우는 5명으로 최종적으로 수술 후 12명에서 사시가 나타났다. 수술 전에는 외사시가 5명, 내사시가 2명이었고, 수술 후에는 외사시가 9명, 내사시가 3명으로 외사시가 내사시보다 흔하였다. 수술 전후 안구정렬에 따라 정위/정위, 정위/사시, 사시/사시의 세 군 간의 비교에서는 정위/사시군에 서 백내장수술 후 시력이 유의하게 낮았으며, 정상안과 백내장안의 시력차이가 유의하게 컸고, 수술시기, 약시 및 구면렌즈대응치는 차이를 보이지 않았다. 결론: 단안 소아백내장에서는 외사시가 가장 흔히 나타나며, 수술 후 시력이 낮은 경우 사시가 발생할 가능성이 높으므로 수술 후 이에 대한 주의 깊은 관찰이 필요할 것으로 생각된다. Purpose: The incidence rate and clinical features of strabismus and factors affecting onset of strabismus were evaluated in patients with unilateral pediatric cataract. Methods: A total of 42 patients who underwent lens removal for treatment of unilateral cataract between January 1996 and January 2011 were evaluated. Patients were divided into 3 groups (Ortho/Ortho, Ortho/Strabismus, and Strabismus/Strabismus) according to preoperative and postoperative ocular alignment. Age at surgery, visual acuity, amblyopia, and spherical equivalent were compared among the 3 groups. Results: Of the total patients, 7 had strabismus preoperatively and 5 developed postoperative strabismus. Thus, a total of 12 patients had postoperative strabismus. Preoperatively, 5 patients had exotriopa and 2 patients had esotropia. Postoperatively, 9 patients had exotropia and 3 patients had esotropia. Exotropia was more common than esotropia. In comparison of the 3 groups, postoperative visual acuity was significantly low, and differences in visual acuity between normal eye and cataract eye were significantly larger in the Ortho/Strabismus group. There were no significant differences among the 3 groups in age at surgery, amblyopia, or spherical equivalent. Conclusions: In the patients with unilateral pediatric cataract, exotropia was the most common type. Because there is a high possibility of postoperative strabismus in patients who had lower postoperative visual acuity, careful observation is needed in these patients.

국내 한의학 학술지에 게재된 사시 관련 논문들의 경향성 분석

김영빈,권강,Kim, Young-Bin,Kwon, Kang 대한한방안이비인후피부과학회 2021 한방안이비인후피부과학회지 Vol.34 No.1

Objectives : Strabismus is a disease that can be observed and treated directly from the outside. Therefore, it is very important in Korean medicine ophthalmology in accessibility to treatment. This study is designed to investigate the trends of strabismus-related studies published in Journal of Korean medicine. Methods : 5 Internet databases were selected to search for the study subject. The following 9 keywords were used; Strabismus, Heterophoria, Binocular vision, Visual acuity, Diplopia, Paralytic, Cover test, Oculomotor nerve paralysis, Abducens nerve paralysis. Through this process, a total of 45 studies were found and analyzed into 5 categories ; publication year, publication journal, number of author, type of article, analyzation of case report. Results : There were 2 review articles, 1 original article and 42 case reports. 5 studies(11.1%) were published in 2004 year. Journal of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology were the most common with 40%. The authors were often 2 and 3 (each 22.2%). In the case report study, the treatment period was most often 1-30 days (35.7%). Conclusions : 42 studies were on paralytic strabismus and 1 study was on paralytic and non-paralytic strabismus. These results represent that the studies are concentrated in case reports about paralytic strabismus, but this seems to be an area to be improved in future research.

중증근무력증 환자에서의 사시수술

천보영,김승현 대한안과학회 2009 대한안과학회지 Vol.50 No.12

Purpose: To report the results of strabismus surgery in five patients diagnosed with myasthenia gravis with strabismus. Case summary: The authors retrospectively analyzed the effect and timing of surgery for patients who developed strabismus after being diagnosed for myasthenia gravis. Cases 1 and 2 were female myasthenia gravis patients, eight and 45 years of age, who underwent surgery after symptoms developed for correction of exotropia at 33 months and ten years after diagnosis, respectively. Case 3 was a 33-year-old male hyperthyroidism patient who had an exotropia operation six years after his strabismus diagnosis. Cases 4 and 5 were a 22–year-old female and a 50-year-old male patient, who underwent surgery for correction of left hypotropia at 14 months and ten months after diagnosis, respectively. Eventually, a total of three cases of horizontal deviation and two cases of vertical deviation had successful outcomes resulting within ten prism diopters. The patients in cases 4 and 5, both of whom had vertical deviations, experienced a short wait time from the date of symptom presentation until they were able to receive surgery. In particular, case 5 developed left hypertropia two months prior to surgery and the strabismus angle increased until six months prior to surgery. However, the hypertropia stabilized afterwards and the patient finally obtained orthophoria after a left inferior rectus advancement operation. Conclusions: In patients diagnosed with myasthenia gravis and a large angle strabismus, a longer follow-up period from diagnosis to operation is necessary for a successful postoperative outcome and stable strabismus angle. 목적: 사시가 동반된 5명의 중증근무력증 환자에서 사시수술을 시행 후 결과에 대해 보고하고자 한다. 증례요약: 중증근무력증으로 진단 후 사시가 발생한 5명에 대해 수술을 시행한 후 후향적으로 분석하였다. 증례 1, 2는 각각 8세 여아, 45세 여자로 사시 발생 33개월, 10년 후에 외사시로 수술을, 증례 3은 갑상선 항진증과 동반된 33세 남자로 사시 발생 6년 후에 외사시로 수술을 시행하였다. 증례 4는 22세 여자로 복시 발생 후 14개월째 하사시로 수술을 시행 받았고, 증례 5는 50세 남자로 복시 발생 10개월 후에 하사시로 수술을 시행하였다. 증례 1, 2, 3은 수평사시, 4, 5는 수직사시로 모든 증례에서 10PD 이내의 수술결과를 보였다. 증례 4와 5는 사시 발생 후부터 수술일까지 시일이 짧았으며 특히 증례 5의 경우 술 후 2개월째 좌안에 상사시가 나타나 6개월까지 진행한 후 안정되는 경과를 보여 좌안 하직근 전진술을 시행한 후 정위를 보였다. 결론: 큰 각의 사시가 동반된 안근무력증 환자에서 술 전 관찰기간을 충분히 하여, 사시각이 안정된 경우에는 사시수술을 시행하여 술 후 안정된 사시각과 만족스러운 결과를 얻을 수 있었다.

소아 사시의 진단과 치료

양희경,정재호 대한의사협회 2019 대한의사협회지 Vol.62 No.6

Strabismus is a pathologic condition in which the eyes do not properly align with each other forming different images on the corresponding retinal points. Early diagnosis and appropriate management of strabismus in the sensitive period of visual maturation is critical for the development of normal binocular vision in children. Therefore, it is important to perform ophthalmologic examinations including cycloplegic refraction and ocular alignment as early as possible to detect risk factors for amblyopia and strabismus. Strabismus could also be a sign of intraocular pathology, brain diseases or myasthenia gravis which may require urgent treatment. Strabismus can be treated by surgical and nonsurgical methods. The first step in the management of strabismus is to correct amblyogenic refractive errors and prescribe glasses if necessary. Bifocal lenses, prism glasses, occlusion therapy, and botulinum toxin injection could also be considered. Surgery is usually performed if non-surgical treatments are unsuccessful. Making an accurate diagnosis and setting practical goals and limitations of treatment is the key to success in the treatment of strabismus.