How to distinguish between true and false strabismus

  Parents find that their children often “eye to eye” (commonly known as: cross-eyed), and rotating toys is not related. The occurrence of “cross-eye” in children, especially in young children who are still in the cradle, should be of great concern to parents, who should take their children to a regular hospital for ophthalmology examination as soon as possible to confirm whether the child is really suffering from internal strabismus (cross-eye).  In the clinic, we often see anxious parents who bring their children with “opposite eyes” to the doctor, only to find out that the child has “pseudo-strabismus” after examination. Parents are confused, they have only heard of “pseudomyopia”, but not “pseudostrabismus”!  In fact, there is a difference between true and false eyes, and some infants and toddlers have flat noses (commonly known as collapsed noses), wide distances between the eyes, and severe inverted eyelashes because their facial contours are not fully developed. Most infants with these facial features have the sign of “medial canthus”, which means that compared to normal children, the inner side of each eye near the root of the nose has an extra half-moon shaped skin wrinkle, resulting in less exposure of the sclera (white eye) of the inner eye, making it easy for onlookers to have the illusion that the cornea (black eye) of both eyes are close to each other, especially when the child When the child looks to the side, the cornea of one eye will be covered by the “inner canthus”, which looks more like the “opposite eye”. This “opposite eye” is called “pseudostrabismus”.  In the case of a child with pseudo-strabismus, simply pinch the skin next to the bridge of the nose with your fingers and gently pinch it symmetrically to expose the medial sclera (white eye) of both eyes, and you will see that the “crossed eyes” disappear immediately. In less serious cases, the “inner canthus” will disappear naturally as the nasal bone grows taller and holds up the excess skin on the inside of both eyes.  There is also a very simple way to help parents determine the authenticity of their child’s “crossed eyes”: at a distance of about one meter from the child’s eyes, use a softly lit flashlight and shine it horizontally toward the root of the child’s nose. In case of “pseudostrabismus”, the light points on both eyes should be located in the center of the pupillary area of the cornea. If one light point is in the center of the pupillary area of the cornea, and the other light point is up and down, or to the left and right, away from the center of the pupillary area, the child has a vertical or horizontal “true strabismus” and should be taken to the hospital immediately.