Evaluation of demographic characteristics and management in cases of paralytic strabismus

Aims: To evaluate the demographic characteristics of cases of paralytic strabismus followed up in our Strabismus Unit and to report on their management and long-term outcomes. Methods: The records of 98 patients diagnosed with paralytic strabismus between 2010 and 2024 at the Strabismus Unit of Fırat University Eye Diseases Clinic were retrospectively reviewed. The diagnosis, etiology, management, and outcomes of the patients were evaluated. Results: The average age of the patients was 16.8±18.5 years, with 48 (48.9%) being female and 50 (59.1%) being male. The average follow-up period was 7.1±6.7 years. The most commonly affected cranial nerve was the 4th cranial nerve, observed in 63 patients (64.2%). The 6th cranial nerve was affected in 25 patients (25.5%), and the 3rd cranial nerve was affected in 10 patients (10.2%). While 4th cranial nerve palsy was mostly congenital, the etiology of 3rd and 6th nerve palsy was due to underlying neurological, traumatic, and vascular causes. Spontaneous recovery was observed in 10 patients, Botulinum toxin injection was administered to 10 patients, and surgery was performed on 75 patients. Three patients were prescribed prismatic glasses. Conclusion: Comprehensive clinical examination, detailed medical history, and neurological and systemic evaluations are required for the effective management of patients with paralytic strabismus. If managed correctly, treatment success is quite high.