Strabismus

• Visual acuity
• Corneal light reflex: Can help differentiate strabismus from pseudostrabismus
• Cover-uncover test
• Why is it important to diagnose and treat strabismus?
  • TO PREVENT AMBLYOPIA!
  • Refer if persistent beyond 2 months of age
• Refer tropias to ophthalmologist as early as 6 weeks of age

Pseudostrabismus

• “False appearance” of esotropia resulting from an optical illusion.
• Infants have a flat nasal bridge early in life; The skin that will eventually cover the lateral aspect of the nasal bridge overlays the adjacent area of the nasal sclera.
• The absence of visible nasal sclera will cause most observers to mentally “explain” that appearance by believing that the eyes must be turned toward each other.
• Diagnosis: Symmetric corneal light reflex.

1. How do you differentiate pseudostrabismus from true esotropia? Corneal light reflex. In pseudostrabismus, the corneal light reflection is in the same position on both pupils.
2. What are you going to tell the parents? Reassurance that the patient will “outgrow” this problem.

CHLA Board Review 2005