Pseudostrabismus

Dr. Burke is one of Cincinnati's most trusted resources concerning pseudostrabismus in infants and toddlers.

What is pseudostrabismus?

Pseudo means “not real” and strabismus refers to an eye misalignment problem. Pseudostrabismus is therefore an illusion causing the eyes to appear as if they were not properly aligned. The most common type of pseudostrabismus is pseudo-esotropia (appearing crossed-eyed).

What is pseudo-esotropia?

Pseudo-esotropia is the false impression that the eyes are crossed. This illusion of crossing is caused by the infant's facial appearance where the folds of skin that cover the bridge of the nose (the space between the eyes) and the shape of the eyelids partially covers the inner corner of the eyes. These features cause less visible white space between the colored part of the eye (iris) and the inner corner of the eyelid. This may give the illusion that the eyes are crossed when looking straight ahead or more commonly when the eyes are turned to either side. This appearance is especially noticeable in photographs.

What should you do if you suspect crossed eyes?

It is common for parents to be concerned about their child's visual development especially when they noticed what appears to be crossed eyes. Misaligned eyes are a true cause for concern and, whenever suspected, requires an examination by a pediatric ophthalmologist. If left untreated, true strabismus can quickly lead to poor visual development in one or both eyes. Children do not outgrow true crossing of the eyes, a type of strabismus called esotropia. Pseudo-esotropia is not true misalignment so is often referred to as being “outgrown”. This is because, in most cases, the facial growth allows the illusion of crossing to “fade away” by the age of 4 to 5 years.

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