Pseudostrabismus explained

Your child has a condition called pseudostrabismus. This leaflet will explain:

• what pseudostrabismus is

• what causes the condition

• how your child will be assessed and treated

• what the benefits are to being assessed; and

• what the risks are if you choose not to have your child assessed.

We hope this leaflet helps to answer some of the questions you may have. If you have any questions or concerns, please speak to a member of your child's healthcare team.

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.

1. 
   True strabismus (squint)
2. 
   Pseudostrabismus

What causes a pseudostrabismus?

The most common cause of pseudostrabismus is epicanthus. Epicanthus 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. This will cause the pseudostrabismus to become less noticeable.

How will my child be assessed?

The appointments with the orthoptist are to observe your child.

• The orthoptist will check your child’s vision, testing the sight of each eye in turn.

• The orthoptist will use a stereopsis test to make sure your child does not have a true strabismus (squint). A stereopsis test:

  • looks at how your child's eyes work together (binocular vision); and

  • shows certain reflexes and 3D vision.

Will my child need to be tested for glasses?

Your child will be a offered a glasses test if:

• there is a family history of glasses from a young age

• a family history of true strabismus; or

• concerns are raised when your child is tested.

The test for glasses is called refraction. It will be done by an optometrist (optician) or an ophthalmologist (eye doctor).

More information is available in the Glasses and testing for glasses (hospital refraction) leaflet.

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?

Assessment at a young age is important, as a squint can develop in children who had a pseudostrabismus as a baby.

Will my child need future eyesight tests?

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.