Adults who present with a squint usually have a well-defined ocular muscle palsy. This can be caused by a pathological process at any point from the brain, through the nerve to the muscle. This will be discussed elsewhere but two important causes are disseminated sclerosis in the younger age groups and hypertensive vascular disease in older patients. Diabetes is another important cause that must be excluded in all age groups.
Some adult squints prove to be concomitant squints neglected from childhood. Sometimes a latent squint, which has been well controlled throughout childhood,breaks down in adult life.
In adult life, a blind eye tends to turn outwards and a divergent squint can be due solely to impaired vision in one eye.
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