Which two eye-related symptoms are commonly seen in spina bifida?

• A. Ptosis and anisocoria
• B. Strabismus and nystagmus
• C. Myopia and glaucoma
• D. Cataracts and diplopia

Answer: (B)

Spina bifida often involves central nervous system structures that coordinate eye movements, and changes in CSF dynamics such as hydrocephalus or Chiari II malformation can disrupt the neural control of the eyes. The two eye signs that commonly appear are strabismus, where the eyes are no longer properly aligned, and nystagmus, which is involuntary, rhythmic movement of the eyes. Strabismus results from impaired cranial nerves or brainstem control of the extraocular muscles, while nystagmus reflects instability in gaze due to affected vestibular-ocular or brainstem pathways. This combination is frequently seen with spina bifida and signals the need for early vision and neurodevelopmental assessment to prevent vision problems like amblyopia.