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What is pseudostrabismus?

Pseudostrabismus is the false appearance of misaligned eyes. When eyes are truly misaligned, the condition is called strabismus. In strabismus, the eyes can drift inward, outward, upward or downward.

Esotropia is the name for the condition where the eyes deviate inward. In pseudoesotropia, the eyes appear to be crossed but are actually straight. This common condition in infants and young children is generally due to 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. This especially becomes apparent when the infant looks to the right or the left. Then, nearly all of the white is covered, and the eyes appear crossed. As the infant’s facial structures mature, this appearance of crossing will improve and often disappear.

Exotropia is the name for the condition where the eyes deviate outward. In pseudoexotropia, the eyes appear to be wandering out but are actually straight. While less common than pseudoesotropia, it also is often due to facial structures. Children with widely set eyes can appear as if their eyes are drifting out.

It is common for parents to be concerned about their child’s visual development, especially when they notice what appears to be crossed eyes. Misaligned eyes are a true cause for concern. If left untreated, strabismus can quickly lead to poor visual development in one eye. Unlike pseudostrabismus, a child does not outgrow true crossing of the eyes. He or she will need ophthalmological treatment to straighten the eyes and allow for normal vision to develop.

An infant’s eyes may drift in or out at times, but this small variable alignment is perfectly normal during the first few months. When a baby begins focusing on the environment, at about two to three months of age, the eyes should be straight most or all of the time.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.