IDEAL goals in the treatment of strabismus include the attainment of single binocular vision with good stereopsis and secure ocular alignment. These aims must often be significantly modified in the presence of organic brain damage, particularly in cases of congenital rubella where the central nervous system involvement is but part of a generalized process of fetal injury which often includes major ocular defects.
The frequency of strabismus in these infants is directly related to the severity of those characteristic rubella defects which primarily reduce vision, and only secondarily to the brain damage. Since the restoration of good vision in each eye is necessary to maintain ocular alignment, strabismus management in such children must include early efforts to obtain a clear visual axis and the subsequent institution of an appropriate aphakic corrective lens soon thereafter. The present discussion will be limited to the early management of strabismus in congenital rubella, that
O'Neill JF. Strabismus in Congenital RubellaManagement in the Presence of Brain Damage. Arch Ophthalmol. 1967;77(4):450-454. doi:10.1001/archopht.1967.00980020452007