Background/aims To investigate the correlation between strabismus and the severity of white matter damage of immaturity (WMDI), based on MRI findings. Although strabismus is commonly associated with WMDI, its clinical features are not well established.

Methods This cross-sectional study involved 73 consecutive patients who visited the department of ophthalmology and were diagnosed with WMDI. The severity of WMDI was graded based on the MRI findings of the patients. All of the patients underwent complete ophthalmic examination, and strabismus was characterised in terms of direction, constancy, and angle of deviation. The prevalence and the characteristics of strabismus and their correlation with the grade of WMDI were investigated.

Results The perinatal characteristics, age at MRI, and the number of MRIs per child did not differ between different grades of WMDI. Refractive errors, found in 56 (76.7%) patients, did not differ between the grades of WMDI either. Strabismus was observed in 38 (52.1%) patients, and its prevalence increased with the grade of the disorder; 20 patients had exotropia and 18 had esotropia. Constant strabismus was found more frequently in patients with higher grade WMDI. However, the direction and angle of deviation did not differ depending on the grade of WMDI.

Conclusions The prevalence of strabismus increased with the severity of WMDI and was higher among patients with WMDI than among healthy individuals. The severity of WMDI might be related to the presence and constancy of strabismus.