Pseudostrabismus

What is pseudostrabismus?

Pseudostrabismus is the term used when a baby's eyes look like they are pointing in different directions even though they are not. The term is derived from strabismus, which is a condition in which the eyes do actually point in different directions (sometimes called crossed eyes).

Sometimes something about a baby's face may make it look like the eyes are pointing in different directions even though they are not. Babies often have a wide, flat nose bridge that can make their eyes appear crossed. Also, babies can have folds in the skin of the inner eyelids that cover the inner white part of the eyes, making their eyes look crossed. The illusion of crossed eyes can be even more pronounced when the baby looks to one side.

How is it diagnosed?

If a baby's eyes appear to be misaligned constantly by the time they are 2 months old or misaligned part of the time by the age of 3 months, the baby should be checked by an ophthalmologist (medical eye doctor). The eye doctor can use simple tests to tell the difference between strabismus and pseudostrabismus. For example, the doctor may hold a small light in front of a child's eyes and look to see whether the reflection of this light is properly centered in each eye. In another test, the doctor covers one of the child's eyes and then the other to see if the eyes shift abnormally when focusing on a near or distant target.

How is pseudostrabismus treated?

No treatment is needed for pseudostrabismus. The appearance of misaligned eyes often improves as a child gets older.

If your child has strabismus rather than pseudostrabismus, your child needs treatment. Untreated strabismus can cause poor vision. If treatment is delayed too long, the loss of vision is permanent.