Pseudostrabismus explained
Information for parents from the Orthoptic Department
This leaflet is not meant to replace the information discussed between you and your doctor, but can act as a starting point for such a discussion or as a useful reminder of the key points.
What is a pseudostrabismus?
A pseudostrabismus or pseudosquint is the appearance of a deviating eye. It may look as though one or both eyes appear to turn in, out, up, or down; but in fact the eyes are straight.
True strabismus (squint)
The light reflection (white dot) is on the edge of the coloured part of the child’s left eye and in the centre of the child’s right eye. The picture below shows a left convergent squint (the child’s eye turns in).
More information on squints is available in the Strabismus (squint) explained leaflet.
Pseudostrabismus
This is where the light reflections (white dots) are in the centre of the eye.
-
True strabismus (squint) -
Pseudostrabismus
What causes a pseudostrabismus?
The most common cause of pseudostrabismus is epicanthus, which are prominent folds of skin over the inside corner of the eye. Epicanthus is often linked with a flat bridge of the nose.
Other causes of pseudostrabismus include:
a large or narrow distance between the eyes
different coloured eyes
asymmetrical (uneven) eyelid positions.
Is it common?
Yes. Many babies have a pseudostrabismus.
What is the treatment?
No treatment is needed. As your child grows the bridge of their nose will develop and the pseudostrabismus will become less noticeable.
How will my child be assessed?
The appointments with the orthoptist are for observation of your child.
The orthoptist will check your child’s vision, testing the sight of each eye in turn.
The orthoptist will make sure your child does not have a true strabismus (squint). This will be done by looking at how their eyes work together (binocular vision), using tests to demonstrate certain reflexes and 3D vision (this test is called stereopsis).
Will my child need to be tested for glasses?
All children will be offered a test for glasses, especially if there is a family history of glasses from a young age or a history of a true strabismus. The test for glasses (refraction) will be done by an optometrist (optician) or an ophthalmologist (eye doctor).
What are the benefits of having my child assessed?
The main benefit is peace of mind, knowing your child’s vision is good and that they do not have a true squint. If this is not the case we will be able to advise you on the best treatment for your child.
Are there risks to not being assessed?
A squint can develop in children who had a pseudostrabismus as a baby, so assessment at a young age is important.
Will my child need future vision assessments?
All children are offered:
a vision test at 4 ½ to 5 ½ years old by the school nurse; and
free eye examinations by an optometrist until the age of 16 years.