Pseudo-strabismus is a common condition that needs to be distinguished from deviation of eyes (true strabismus). With pseudo-esotropia, the infant usually has a wide nasal bridge and wide, prominent lid folds, giving the appearance of eyes crossing. But, in fact, the eyes are straight. When the child looks to either side, the eye hides behind the eyelid folds or wide bridge and looks like they are crossing. It is important to document proper eye alignment in these cases by an orthoptic examination.
Comprehensive ocular examination and follow-up is important in patients diagnosed with pseudo-strabismus, as a small percentage of these patients will develop a true esotropia.
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