The purpose of this paper is an attempt to review the major theories proposed which explain the causes of horizontal functional deviations. Functional being defined here as those cases not attributed to any specific physical defect, pathology, or syndrome. Hence, anatomical and mechanical theories, in addition to strabismus secondary to systemic and ocular syndromes will not be covered in the following text. The etiologies of strabismus are numerous and widely varied ranging from accommodative to reflexologic to neurologic. Although many of the proposed theories are plausible explanations, some are more powerful than others. There is not one proposal in particular, that can account for all types of strabismus. In fact, there may be several, depending upon the condition and individual. Future studies and research are indicated which will better enable us to understand and treat each condition appropriately.
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