Degraded oculomotor function and its implications on balance in pediatric strabismus

Children with visual impairment often exhibit poor postural control. However, the effects of strabismus on oculomotor system components and its impact on balance in children are not yet fully understood. This study aims to determine the potential effects of oculomotor functions on balance skills in children with strabismus.

A total of 30 children aged between 6 and 10 years participated in this study. Fifteen children diagnosed with strabismus were included in the strabismus group (8.07 ± 1.33 years), and 15 healthy children without any vision problems were included in the control group (8.03 ± 1.49 years). All children underwent a comprehensive hearing evaluation, bedside neurological and balance examinations, the Pediatric Balance Scale (PBS) assessment to assess balance function, and Videonystagmography (VNG) tests to measure oculomotor function.

In the saccade test, no significant differences were found between the groups in terms of latency, accuracy, and speed (p > 0.05). The strabismus group showed significantly lower pursuit test gains (except the left eye at 0.4 Hz) (p < 0.05) and significantly higher asymmetries (except the right eye at 0.4 Hz) (p < 0.05). No significant difference was observed between the groups in optokinetic test gains (p > 0.05). The strabismus group had significantly lower scores on the 360-degree rotation task (10th item) (p = 0.027) and total PBS scores (p = 0.029). Correlation analysis revealed statistically significant negative correlations between strabismus angle and optokinetic test gains, pursuit test gains, and PBS total scores, with varying correlation strengths (p < 0.05 and − 0.639 < r <  − 0.338).

Strabismus adversely affects the optokinetic and pursuit systems, as well as balance in children. Furthermore, an increase in the strabismus angle is associated with greater adverse effects on these functions. The lower scores obtained in the PBS scores of the strabismus group indicate that strabismus may negatively affect balance skills in activities of daily living. Early intervention and targeted therapies should be considered to mitigate these effects and support the development of balance skills in children with strabismus.