Pseudo-internal strabismus is more common in clinical practice and needs to be differentiated from internal strabismus. Children with pseudo-internal strabismus usually have a wide nasal bridge and an inner canthus, giving the impression that the eye is inwardly slanted. However, in reality, the eye position is in an orthogonal position. When the child looks to the sides, the inwardly rotated eye is hidden behind the canthus and looks like an internal oblique. The Hirschberg corneal reflectance test is very important in the differential examination, in which a beam of light is shone on both eyes simultaneously to observe the position of the corneal reflection points in both eyes. If the eye is orthotropic, the beam will reach the same point on the cornea of both eyes. When the doctor does the test, the child’s family can be allowed to observe together, so that the patient’s family can understand the actual position of the child’s eyes.