Misalignment of the eyes in adults, either persistent from childhood or newly acquired. Can cause double vision, eye strain, and difficulty with depth perception. New-onset in adults often indicates underlying neurological or medical condition requiring evaluation.

• 1Cover test
• 2Alternate cover test
• 3Prism measurements
• 4Ductions/versions
• 5Forced duction testing
• 6Neurological exam (new onset)
• 7Orbital imaging (if restriction)

Good with treatment. Surgery successful in 80-90%. Prism glasses helpful for many. Some adapt to diplopia. Underlying cause must be addressed if acquired. Improvement in quality of life.

• Early childhood treatment
• Manage systemic conditions
• Prompt evaluation of new-onset
• Regular eye exams
• Protective eyewear