Pseudostrabismus is the false appearance of crossed eyes. When the eyes are actually crossed or not completely aligned with one another, it is called

strabismus Strabismus is a vision disorder in which the eyes do not properly align with each other when looking at an object. The eye that is focused on an object can alternate. The condition may be present occasionally or constantly. If present during a ...

. Pseudostrabismus is more likely to be observed in East Asian or Native American infants, due to the presence of

epicanthic folds An epicanthic fold or epicanthus is a skin fold of the upper eyelid that covers the inner corner (medial canthus) of the eye. However, variation occurs in the nature of this feature and the possession of "partial epicanthic folds" or "slight ...

obscuring the medial aspect of each eye. Pseudostrabismus generally occurs in infants and

toddler A toddler is a child approximately 12 to 36 months old, though definitions vary. The toddler years are a time of great cognitive, emotional and social development. The word is derived from "to toddle", which means to walk unsteadily, like a child ...

s, whose facial features are not fully developed. The bridge of their nose is wide and flat, creating

telecanthus Telecanthus, or dystopia canthorum, refers to increased distance between the inner corners of the eyelids (medial canthi), while the inter-pupillary distance is normal. This is in contrast to hypertelorism, in which the distance between the w ...

(increased distance between medial

canthus The canthus (pl. canthi, palpebral commissures) is either corner of the eye where the upper and lower eyelids meet. More specifically, the inner and outer canthi are, respectively, the medial and lateral ends/angles of the palpebral fissure. T ...

of both eyes). With age, the bridge will narrow, and the

epicanthic fold An epicanthic fold or epicanthus is a skin fold of the upper eyelid that covers the inner corner (medial canthus) of the eye. However, variation occurs in the nature of this feature and the possession of "partial epicanthic folds" or "slight ...

s in the corner of the eyes will go away. This will cause the eyes to appear wider and thus not have the appearance of strabismus. To detect the difference between strabismus and pseudostrabismus, clinicians use a flashlight to shine into the child's eyes. When the child is looking at the light, a reflection can be seen on the front surface of the pupil. If the eyes are aligned with one another, the reflection from the light will be in the same spot of each eye. If strabismus is present, the reflection from the light will not be in the same spot of each eye. Rakel's ''Textbook of Family Medicine'' states, "A common misconception is that children with crossed eyes outgrow the condition, but this is generally not the case. This belief stems from the confusion between true strabismus and pseudostrabismus. When a child's eyes are truly crossed, it is always a serious condition and requires the care of an ophthalmologist.There is no treatment required if the child is having pseudostrabismus as the eyes are properly aligned."Rakel, R. E. (2002). Textbook of Family Medicine. Philadelphia: Elsevier.

References

American Academy of Ophthalmology
Eye diseases {{eye-stub