Craniosynostosis is the premature and pathological fusion, either partial or complete, of one or more cranial sutures. One of the ophthalmological complications is strabismus (in 39–76% of cases), with more severe manifestations in syndromic craniosynostosis. Head-CT with 3D-reconstruction can be used to evaluate the anatomical abnormalities of the orbital aspects to assist clinicians in planning surgery. Materials and Methods: A retrospective descriptive–observational study was conducted for 43 patients in the period from January 2017 to March 2022. The patients had syndromic or non-syndromic craniosynostosis and underwent head CT-scans at Dr. Soetomo General Hospital, Surabaya. The posterior orbital bones, orbital apexes, positions and axes of the extraocular muscles were evaluated by an neuroimaging radiology consultant. Results: 26 male subjects (60.5%) and 17 female subjects (39.5%) were evaluated. 18 patients (41.9%) had normal posterior orbital configurations and extraocular muscles, 4 (9.3%) showed mild abnormalities, 13 (30.2%) had moderate abnormalities, 2 (4.7%) showed moderate–severe abnormalities, and 6 (11.6%) had seesaw pattern abnormalities. 33 patients (76.7%) had normal orbital apex configurations, 3 (7%) showed ballooning ethmoidal sinuses, 2 (4.7%) had protrusions of the lateral orbital wall (greater sphenoid wing), and 5 (11.6%) showed combined ethmoidal sinus ballooning and protrusion of the lateral orbital wall. Conclusion: The smallest excyclorotation was observed for the mild abnormalities of the posterior orbital configuration and extraocular muscles in the right eye (4.5–11.3°) and left eye (3.6–7°). The greatest was noted for the seesaw pattern in the right eye (7.6–21.4°) and left eye (7.4–30°). 3 patients (7%) had an incyclorotated axis and 26 (60.5%) had an excyclorotated axis, with a greater degree of excyclorotation in the seesaw pattern.

orbital

craniosynostosis

strabismus

excyclorotated

strabismus

ct-scan