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Pseudostrabismus is the false appearance of misaligned eye. When the
eyes are truly misaligned, the condition is call strabismus. In
strabismus, the eyes can drift in, out, up or down.
In
pseudoesotropia, the eyes appear crossed in but are actually
straight. This is common in infants and young children due to their
facial structures. The wide bridge of the nose and small folds of
eyelid skin on the nasal side of the eye contribute to this appearance
by covering the “white” of the eye on that side. This is especially
noticed when the infant looks to the right or left. As the child
grows, this appearance will improve and disappear.
In
pseudoexotropia, the eyes appear to wander out but are actually
straight. It is also often due to facial structures especially in
children with wide set eyes.
How can you tell the difference?
To
tell the difference between strabismus and pseudostrabismus, shine a
flashlight on your child’s eyes. When you are certain that your child
is looking at the light, observe the light reflection on the surface
of the pupil.
If
both eyes are aligned, the light reflection will appear to be in the
center of each pupil. If a child has true strabismus and the eyes are
not properly aligned, the reflection will appear in a different
location in each eye. (Usually shifted towards the nose, or conversely
towards the ear.) Because the light is not affected by the width of
the nose or the folds of eyelids skin a child with pseudostrabismus
will have a normal reflection.
In some cases, the difference between pseudostrabismus
and true strabismus can be difficult to detect. See your
ophthalmologist if you have any questions.
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