From the Guidelines
False strabismus in babies, also known as pseudostrabismus, is a common condition that typically requires no treatment as it resolves on its own with facial development. This condition is often caused by facial features such as a wide nasal bridge, prominent epicanthal folds, or a flat nasal bridge that creates an optical illusion of crossed eyes. To distinguish false strabismus from true strabismus, parents can look at the light reflection in their baby's eyes—in false strabismus, the light reflections appear symmetrically positioned in both eyes 1. Some key points to consider about false strabismus in babies include:
- It is not a true eye alignment problem and usually resolves by age 6-12 months as the baby grows and facial features develop.
- If concerned about a baby's eye alignment, taking photos with flash to check light reflections or consulting a pediatrician for simple eye tests like the corneal reflex test, cross cover test, and random dot E stereo test can be helpful 1.
- True strabismus, which can represent serious orbital, intraocular, or intracranial disease, requires medical attention, so if persistent eye turning is noticed, especially after 4 months of age, a professional evaluation is necessary to rule out vision problems. Given the potential for true strabismus to indicate serious underlying conditions, it's crucial for parents to be aware of the differences and seek medical evaluation if they have concerns about their baby's eye alignment.
From the Research
Definition and Prevalence of False Strabismus in Babies
- False strabismus, also known as pseudostrabismus, is a condition where a baby appears to have crossed eyes or strabismus, but it is not a true case of strabismus 2.
- According to a study published in the American Journal of Ophthalmology, the birth prevalence of pseudostrabismus in the first year of life is 1 in 113 children 2.
Diagnosis and Follow-up of False Strabismus
- A retrospective population-based cohort study found that 89.7% of infants initially diagnosed with pseudostrabismus by a non-ophthalmology care provider were confirmed by an ophthalmologist 2.
- The study also found that 49.4% of infants had at least one follow-up visit with an ophthalmologist, with a median follow-up time of 7.7 years 2.
Relationship between False Strabismus and True Strabismus
- The same study found that 4.9% of infants with pseudostrabismus were subsequently diagnosed with strabismus at a mean age of 4.5 years 2.
- This suggests that while pseudostrabismus is not a true case of strabismus, it may be a precursor to or associated with an increased risk of developing true strabismus.
Treatment and Management of Strabismus
- Other studies have explored the treatment and management of strabismus, including the role of optometric vision therapy 3 and patching after strabismus surgery 4.
- Refractive surgery has also been investigated as a means of treating strabismus, as well as a potential cause of strabismus and binocular diplopia 5.