How does strabismus typically present in retinoblastoma cases?

Strabismus in cases of retinoblastoma often presents as esotropia or exotropia. This misalignment of the eyes occurs because the tumor can affect the optic nerve and the normal function of the eye muscles, leading to issues with eye coordination. In retinoblastoma, the tumor may cause the affected eye to turn inward (esotropia) or outward (exotropia), which can often be one of the noticeable signs that prompts further examination.

Other visual disturbances such as changes in the size of the pupil or differences in how the eyes focus may also be present, but esotropia or exotropia specifically indicates a clear misalignment that characterizes strabismus. This aspect of strabismus is particularly important in pediatric screenings, as early detection can lead to timely intervention and improve outcomes for the child.