Abstract
PURPOSE: Strabismus is a major cause of ocular morbidity worldwide. Despite its prevalence, there is a limited understanding of its epidemiology and associated factors, particularly across diverse populations. METHODS: This hospital-based, cross-sectional observational study included all patients diagnosed with strabismus at a tertiary care center between January 1 and December 31, 2023. A consecutive sampling method was used. Each patient underwent a comprehensive ophthalmic and strabismus examination, which included best-corrected visual acuity, cycloplegic refraction, and a detailed ocular history. Data were collected using a structured, interview-based proforma covering demographics, family history, medical history, and ocular history. The primary aim was to determine the distribution of strabismus types; secondary objectives included analyzing associated clinical and social factors. RESULTS: Among 75,917 new patients visiting the hospital, 1.5% (n = 1131) had strabismus. Exotropia slightly outnumbered esotropia (49.6% vs. 41.4%), with intermittent exotropia being the most common subtype. The highest hospital frequency was in children aged 1-6 years (37.4%) and the lowest in infants under 1 year (1.1%). Key associated factors included preterm birth, prolonged postnatal ICU stay, cesarean delivery, and cerebro-visual impairment. Refractive errors (20.2%) and amblyopia (13%) were common comorbidities. CONCLUSIONS: Strabismus remains a significant pediatric ocular issue, particularly in children under 6 and those with perinatal complications. Early screening and intervention in associated groups-such as preterm infants and those with developmental delays-are essential to reduce long-term visual impairment. Strengthening primary pediatric eye care is crucial for early detection and treatment.