The common pseudo “eye strabismus” is divided into pseudo internal strabismus and pseudo external strabismus. Pseudostrabismus is often confused with true strabismus and is not immediately recognizable, and even experienced clinicians have to repeatedly examine it several times before they can determine it correctly. How to determine pseudostrabismus? Experts point out that pseudostrabismus is mainly due to excessive pupil distance, which can cause a sense of exotropia. The causes of pseudo-exotropia are: 1, intermittent internal strabismus in infants: mainly occurs in infants born within 4 months, both eyes cause both eyes to converge when looking at near objects, and intermittent internal strabismus appears. 4-6 months later, when the eyes begin to adjust, the internal strabismus can disappear on its own. 2.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 baby is too wide, which gives a feeling of internal strabismus (opposite eye) from the appearance. When the child’s eye is turned to the left or right, the inwardly turned eye appears more obvious. The way to identify this is to pinch up the skin at the root of the child’s nose to expose more of the sclera on the side of the nose, and the “internal strabismus” will disappear. In addition, you can also use the corneal reflection method, i.e., shine a flashlight between the child’s two eyes and observe whether the light is in the middle of the cornea; or check the eye position by alternately covering one eye to identify. 3, pupil distance is too small: when the orbital distance and pupil distance between the two eyes is too small, it will give the impression of internal strabismus.