The purpose of this study was to retrospectively assess the aetiology of paediatric ocular cranial nerve palsies (CNP) using neuro-ophthalmic data from three hospitals. The study included 1263 patients aged <18 years suspected of having strabismus, from January 1999 to June 2012. 53.4% were female and average follow-up was 14 years. Thirty-three patients had paralytic strabismus with at least six months follow-up. One case was bilateral, and the remainder were unilateral. Mean age at diagnosis was 5.9 ±4.5 years. Over half (54.2%) were aged