What finding suggests that a school-age child may need to be evaluated for strabismus?

The presence of movement of the uncovered eye during a cover test is a strong indicator that a child may have strabismus, which is a condition where the eyes do not properly align with each other when looking at an object. In a cover test, one eye is covered while the other eye is observed. If the uncovered eye moves to fixate on the target when the other eye is covered, it suggests that the covered eye was misaligned and the brain has been compensating for this misalignment.

This finding points to a potential ocular alignment issue, which is critical for proper binocular vision and depth perception. Early detection and evaluation of strabismus are essential, as untreated conditions can lead to amblyopia, or "lazy eye," where vision in one eye becomes weaker than the other.

In contrast, diminished ability to read may stem from a variety of educational or developmental issues rather than specifically indicating strabismus. Inconsistent eye dryness does not directly relate to eye alignment or strabismus. Difficulty recognizing faces could be a cognitive or social skill issue rather than a visual alignment problem. Therefore, the cover test providing evidence of eye movement is a pivotal indicator for evaluation of strabismus.