Strabismus and child abuse

My son who is 12 1/2 suddenly came up with strabismus after moving in with his father 6 months ago. He has always had perfect vision and has had regular eye screenings since he was an infant. His girlfriend took my son in to have his eyes checked and they gave the diagnosis. There is no family history on either side and when I took m daughter back to the same physician a week later for her annual screening I asked what could possibly cause the condition to come on so suddenly and at his age. I was told that it was extremely rare for strabismus to suddenly come on in a child over the age of three, especially one who has been seeing an eye doctor yearly and that head trauma could be the cause. Is it possible for child abuse to lead to this condition. My ex husband has a history of violent behavior.

[John C Hagan III, MD, FACS, FAAO]

You were given bad information. Strabismus or eye muscles problems in children over three is not rare in face age 2 to 4 is the most common age for accommodative esotrophia.

There is a big difference between eyes caused by strabismus and that caused by head trauma. The differece is that the spontaneious onset is symmetrical (commitant) while the crossing due to injury is assymetrical (incommitant).

Trauma to a child usually results in bleeding into the back of the eye.

If you have joint custody you can always take the child to a pediatric ophthalmologist of your chosing for a second opinion.

JCH III MD

[jerry335]

Granted in the case illustrated, the mother indicates physical violence. But could the cause of Strabismus be psychological abuse, for instance neglect, or deprived indifference.  

Thank You
Jerry Stevenson
gerald_s_08873***@****

[John C Hagan III, MD, FACS, FAAO]

No.

JCH MD

[jerry335]

I disagree, and here is the basis of my argument.
    Whether it be Strabismus or lazy eye, knowing what we do now of psychology and the early development of the neural pathways,and I will point to the development of the brain in newer textbooks. An abrupt change in nurturing and depraved indifference in my opinion could cause the fine motor control of one of the more delicately controlled organs of the body to exhibit these symptoms. What is your opinion?
     I appreciate your feedback and thank you.

[John C Hagan III, MD, FACS, FAAO]

It's your opinion and that's fine, there is nothing factual or in evidence based medicine to support your opinion.  

JCH MD

[jerry335]

There is nothing factual or in evidence based medicine because it is psychological and not tangible, like physical abuse, and probably not been researched.  
I will add that I am a 52 year old male with this condition in my left eye, that was observed by a physician when I was aprox. 6 years old. My daughter who is now 22, exhibited these symptoms some time after her mom and I divorced after her 6 year of life. We have joint custody. I come from a large family and there are no others that I know of that exhibit these symptoms.

Thank You for your feedback