Pseudo-strabismus

What is pseudo-strabismus?

When the eyes are not in line with each other this is known as strabismus. This is more commonly called a squint.

Pseudo-strabismus is the appearance that the eyes are not in line with each other even though the eyes are normally aligned.

Pseudo-strabismus is caused by your child’s facial features, usually a broad nose bridge which is very common in babies and young children.
This wide nose bridge nose gives the appearance that the eyes have moved inwards towards the nose.

It is common for parents and carers to be concerned about their child’s visual development, especially when they notice what appears to be ‘crossed eyes’. An infant’s eyes may drift in or out at times during the first few months after being born but this is perfectly normal. When a baby begins focusing on things around 4 months of age the eyes should be straight most or all of the time.

How can you tell the difference?

To tell the difference between a real strabismus and pseudo-strabismus, shine a light into your child’s eyes. A reflection can be seen on the front surface of the eye, this will look like a white dot.

With a pseudo-strabismus the light reflection will be in the same place in each eye, usually the centre of the pupil and symmetrical, as shown above.

True strabismus

With a genuine strabismus the reflection will appear in a different location in each eye, usually one reflection is in the pupil and one is in the iris (the coloured part of the eye) like in the photo below.

Treatment

A pseudo-strabismus does not need treatment and it is possible you will notice this less as your child grows and their facial features develop. A genuine strabismus can lead to poor vision in one eye and may need treatment with glasses or patches. If you are noticing this, then please contact your GP or the eye department again.