Pseudoesotropia

Updated: Oct 14, 2015
  • Author: Kalpana K Jatla, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Background

Pseudoesotropia is a condition in which the alignment of the eyes is straight (also known as orthotropic); however, they appear to be crossed. [1]

Note the cross-eyed appearance of the right eye in Note the cross-eyed appearance of the right eye in the top image that corrects with elimination of the prominent epicanthal fold.
In these photos of the same child as in the previo In these photos of the same child as in the previous image, note the cross-eyed appearance of the left eye in the top image that corrects with elimination of the prominent epicanthal fold. Also, note that corneal light reflex demonstrates straight alignment.
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Pathophysiology

This condition most commonly occurs in infants when a flat nasal bridge and prominent epicanthal folds tend to obscure the nasal portion of the sclera. This optical illusion causes the patient to have an appearance of eyes deviated nasally, and it is most apparent when the eyes are in side gaze or are focusing up close. A small interpupillary distance (ie, the distance between 2 pupils) also can give the appearance of pseudoesotropia. [2]

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Epidemiology

Frequency

United States

Pseudoesotropia is a condition with variable frequency. This condition is one of the most common reasons for infant referrals to ophthalmologists.

Race

Infants or young toddlers of Asian descent with flat nasal bridges often have pseudoesotropia.

Sex

No gender predilection exists in pseudoesotropia.

Age

Pseudoesotropia is more frequent in infants and toddlers where facial structures have not yet fully developed.

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