User:Nabor Barbera/pseudostrabismus

Pseudostrabismus is the false impression that the eyes are misaligned, which may lead to the incorrect diagnosis of strabismus. Distinguishing between pseudostrabismus and true strabismus is important in newborns, infants and toddlers because untreated strabismus can cause vision loss from reduced depth perception or amblyopia. Acquired pseudostrabismus may be a sign of other eye disease.

The impression of pseudostrabismus in infants and toddlers occurs because the facial features are not fully developed, and the bridge of the nose is wider and flatter. This is especially true when epicanthal folds are present.

In Western populations, the epicanthal folds and associated pseudostrabismus may disappear with age and facial development. Persistent epicanthal folds occur with high frequency in specific Asian and Pacific Island populations, and in indigenous peoples of the Americas.

Facial or eyelid asymmetry, and displacement of the fovea can also cause pseudostrabismus. These may be congenital, or acquired as in cases of orbital tumor, orbital fracture, thyroid eye disease or retinal disease causing foveal displacement, like retinopathy of prematurity or retinal infection.

A skilled observer can distinguish pseudostabismus from strabismus using the corneal light reflex test (also known as the Hirschberg test) and other testing. This evaluation should be performed by an ophthalmologist or other trained professional.