Pseudostrabismus is often confused with true strabismus and does not allow one to tell at a glance that it is pseudostrabismus; even experienced clinicians have to go through many repeated examinations to determine it correctly. Many parents see their children with obvious strabismus, so how can they say it is not strabismus? Is it because the doctor did not examine carefully. A case like this, where there is a strabismus from the appearance, but in fact there is no strabismus and the eye position is normal, belongs to pseudostrabismus and does not require treatment. Pseudostrabismus is mainly caused by a large pupil distance, which can cause a sense of exotropia. If the eye position is normal, it is a pseudostrabismus and does not require treatment. Causes of pseudostrabismus 1. Intermittent internal strabismus in infants. It occurs mainly in infants within 4 months of birth. When both eyes look at near objects, it causes both eyes to converge, resulting in intermittent internal strabismus, which can disappear on its own after 4-6 months when the eyes start to adjust. 2. Pupil distance is too small. When the distance between the orbital distance and pupil of both eyes is too small, it will give people the feeling of internal strabismus. 3.Internal strabismus. This condition is most easily mistaken for internal strabismus and is one of the most common types of pseudostrabismus. It is due to the fact that the internal redundant skin of the eye covers the internal redundant part of the eye, and in severe cases, it can cover part of the sclera, so that the sclera on the nasal side is less exposed than on the temporal side, and the nasal root of the infant is too wide, giving a feeling of internal strabismus (opposite eye) from the appearance. When the child’s eye is turned to the right or left, the inwardly turned eye appears more obvious. Identification The identification of internal strabismus is done by examining the eye position by alternating the covering of one eye. If the skin at the root of the nose is pinched up and the sclera on the side of the nose is exposed more, the “internal strabismus” will disappear. In addition, we can also use the corneal reflection method, that is, shine a flashlight between the child’s two eyes and observe whether the light shadow is in the middle of the cornea. Preventive health care methods for strabismus The masking therapy should be removed gradually when the vision returns to normal. First, open the mask for 2 hours a day, and then extend the opening time to 4 hours a day after 1 month, and later to 6 hours, 8 hours, until the whole day open or change from full mask to half mask to consolidate the effect. During the consolidation period, no relaxation of fine work. If a decrease in visual acuity is found in the amblyopic eye, the healthy eye can be re-covered and the amblyopic eye can still be improved to its original level. After normal vision, the eye should be reviewed once a month for the first 6 months, and then once every 3 months or half a year until it is completely cured after 3 years of follow-up. In addition to vision enhancement therapy for strabismus, it is also crucial to train the monocular function and fusion power of both eyes. If it is found that the visual acuity decreases, the posterior image therapy should be resumed. The posterior image therapy should not be stopped suddenly, but should be gradually reduced in number and extended interval and stopped slowly, and after stopping, the amblyopic eye should be often used to watch movies, TV, write small words, do fine work, or do drawing games on the carousel painted with black and white lines, through these simple and easy methods to stimulate the macular function and prevent regression.