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Pseudoexotropia

  • Author: Barbara L Roque, MD, DPBO, FPAO; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Apr 06, 2016
 

Background

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

See related CME at Highlights of the American Association for Pediatric Ophthalmology and Strabismus Annual Meeting.

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Pathophysiology

Pseudoexotropia occurs with a wide interpupillary distance or a positive angle kappa. Angle kappa is the angle formed between 2 imaginary lines: the visual axis and the pupillary axis. To construct the visual axis, extend a straight line from the viewing object through the nodal point. A straight line going through the center of the pupil and perpendicular to the corneal plane constructs the pupillary axis. Since fovea is displaced temporally, a small angle kappa (up to 5°) manifests as a nasally displaced corneal light reflex. Children may falsely appear to have an exotropia when they look to the side.

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Epidemiology

Frequency

United States

The incidence of pseudoexotropia is higher in children with a temporally dragged macula from retinopathy of prematurity.

Sex

No known sexual predilection exists.

Age

The appearance of pseudoexotropia is seen at any age.

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Contributor Information and Disclosures
Author

Barbara L Roque, MD, DPBO, FPAO Senior Partner, Roque Eye Clinic; Chief of Service, Pediatric Ophthalmology and Strabismus Section, Department of Ophthalmology, Asian Hospital and Medical Center; Active Consultant Staff, International Eye Institute, St Luke's Medical Center Global City

Barbara L Roque, MD, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Philippine Society of Cataract and Refractive Surgery, Philippine Academy of Ophthalmology, Philippine Society of Pediatric Ophthalmolo

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Gerhard W Cibis, MD Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas School of Medicine

Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Ophthalmological Society

Disclosure: Nothing to disclose.

S Anna Kao, MD Comprehensive Ophthalmologist, Emory Clark Holder Clinic; Staff Physician, Department of Ophthalmology, West Georgia Medical Center

S Anna Kao, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Robert William Enzenauer, MD, MPH, MBA, MSS Professor, Department of Ophthalmology, University of Colorado School of Medicine; Chairman, Department of Ophthalmology, Children's Hospital

Robert William Enzenauer, MD, MPH, MBA, MSS is a member of the following medical societies: American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Association for Physician Leadership, American Academy of Ophthalmology

Disclosure: CLEAR DONOR: Received consulting fee from Clear Donor for consulting; Partner received salary from Clear Donor for employment.

Kenneth T Horlander, MD, FCCP Director, Pulmonary Rehabilitation Program, Physician in Pulmonary Medicine and Critical Care Medicine, Emory Clark-Holder Clinic; Director, Medical and Surgical Intensive Care Unit, Physician in Pulmonary Medicine and Critical Care Medicine, West Georgia Health System

Kenneth T Horlander, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Diabetes Association, American Medical Association, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Kalpana K Jatla, MD Private Practice, Clarity Eye Center

Kalpana K Jatla, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

References
  1. Catalano RA, Nelson LB. Pediatric Ophthalmology: A Text Atlas. 1994. Vol 25: 100-2.

  2. Wright K. Pediatric Ophthalmology and Strabismus. 1995. 192.

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