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Objective: To prospectively study infants of birth weight less than 1701 g in the East Midlands of England in the mid 1980s at 10 to 12 years of age to determine the incidence and risk factors for strabismus in children born preterm. Methods: Low-birth-weight children (n=572) who had been examined during the neonatal period were invited for a follow-up visit at age 10 to 12 years; 169 eleven-year-old schoolchildren born at full term were also recruited (the school cohort). Results: Of the original 572 children, 293 consented to further examination. There was no significant difference between children who were examined and those who were not in terms of birth weight, gestational age, retinopathy of prematurity, and cranial ultrasound abnormalities. Compared with the school cohort (n=5 [3.0%]; 95% confidence interval, 1.0%-9.1%), the low-birth-weight cohort had a significant increase in the prevalence of strabismus (n=59 [20.1%]; 95% confidence interval, 15.9%-25.0%; P Conclusions: The results of this study confirm the increased prevalence of strabismus in a low-birth-weight population. This study also provides more detailed information on risk factors and strabismus types. Arch Ophthalmol. 2002;120:767-773