Sudden Strabismus in a 22-Year-Old Female Student: Should She Seek Help?

Sudden onset of esotropia in a female college student?

I would like to consult with a physician regarding a 22-year-old female college student who recently started an internship at a hospital.
While resting at home, she suddenly noticed that her right eye was deviating inward towards the nose (both eyes were normal before).
She has mild myopia of over 200 degrees but does not report any blurred vision or headaches; it was just the observation of the eye turning inward, which returned to normal after moving her head.
This incident occurred again recently, but it also resolved after moving her head.
I would like to ask the physician if she needs to see an outpatient clinic.

Zhongbu Kelake Jianxusheng, 20~29 year old female. Ask Date: 2016/04/02

Dr. Wang Zhangji reply Ophthalmology

For symptoms such as latent strabismus, it is recommended to undergo a detailed examination by a strabismus specialist.

Reply Date: 2016/04/02

More Info

Sudden strabismus, or misalignment of the eyes, can be concerning, especially when it occurs suddenly in a young individual like your 22-year-old sister. While she may not be experiencing other symptoms such as blurred vision or headaches, the fact that her eye has deviated towards the nose (esotropia) warrants further evaluation by a healthcare professional.

Strabismus can be caused by a variety of factors, including muscle imbalances, neurological issues, or even systemic conditions. In young adults, sudden onset strabismus can sometimes indicate a more serious underlying condition, such as cranial nerve palsy, which may affect the muscles controlling eye movement. Other potential causes could include thyroid eye disease, which can lead to muscle swelling and misalignment, or even a transient ischemic attack (TIA) in rare cases, particularly if there are other risk factors present.

Given that your sister's strabismus has occurred more than once and resolves temporarily, it is essential to consider a few key points:
1. Frequency and Duration: The fact that this has happened multiple times suggests that it is not an isolated incident. Even if the episodes are brief, the recurrence is significant.

2. Potential Underlying Causes: While she may not have other symptoms currently, the presence of strabismus could indicate an underlying issue that may not yet be symptomatic. Early detection of conditions that could lead to more severe complications is crucial.

3. Impact on Daily Life: Even if she feels fine otherwise, strabismus can affect depth perception and overall visual comfort, which may impact her daily activities, especially as a student.

4. Professional Evaluation: A comprehensive eye examination by an ophthalmologist or an optometrist is recommended. They can perform tests to assess her eye alignment, muscle function, and overall eye health. If necessary, they may refer her to a neurologist for further evaluation.

5. Peace of Mind: Seeking medical advice can provide reassurance. Understanding the cause of her symptoms can alleviate anxiety and help her manage any potential issues proactively.

In conclusion, I strongly recommend that your sister seek medical attention. An eye care professional can provide a thorough assessment and determine if any treatment or further investigation is needed. Early intervention can be crucial in preventing potential complications and ensuring her visual health remains intact. Encourage her to make an appointment as soon as possible to address this concerning symptom.

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