Pseudostrabismus

Pseudostrabismus

An example of epicanthic folds, which can contribute to pseudostrabismus.

Pseudostrabismus is a condition in which the eyes appear to be misaligned, but upon closer examination, they are actually properly aligned. This condition is often observed in infants and young children and is usually due to anatomical features rather than any true misalignment of the eyes.

Causes

Pseudostrabismus is primarily caused by certain facial features that create the illusion of strabismus. The most common features include:

• Epicanthic folds: These are skin folds of the upper eyelid that cover the inner corner (medial canthus) of the eye. They are common in certain ethnic groups and can give the appearance of esotropia (inward turning of the eyes).
• Wide nasal bridge: A broad nasal bridge can also contribute to the appearance of pseudostrabismus by obscuring the sclera (white part of the eye) on the nasal side.
• Prominent epicanthal folds: These folds can make the eyes appear closer together or misaligned.

Diagnosis

The diagnosis of pseudostrabismus is typically made by an ophthalmologist or an optometrist. The examination includes:

• Corneal light reflex test: This test involves shining a light in the eyes and observing the reflection on the cornea. In pseudostrabismus, the light reflex will be symmetrical, indicating proper alignment.
• Cover test: This test involves covering one eye and observing the movement of the uncovered eye. In pseudostrabismus, there will be no movement, indicating that the eyes are aligned.

Management

Pseudostrabismus does not require treatment as it is not a true misalignment of the eyes. However, it is important to differentiate it from true strabismus, which may require intervention. Parents are often reassured that the condition is benign and that the appearance may improve as the child grows and facial features develop.

Related pages

• Strabismus
• Epicanthic fold
• Ophthalmology