The authors aimed to evaluate the incidence of strabismus in children initially diagnosed with pseudostrabismus and identify risk factors for development of strabismus. This was a retrospective review of 65 patients with a diagnosis of pseudostrabismus; two exo and 63 eso appearance. Mean age at initial examination was 29.26±26.68 months; 40% were female. Mean follow-up was 25.2±23.28 months; 7.6% had a family history of strabismus and 9.2% had a history of prematurity; 53.8% had epicanthus, 26.2% with a flat broad nasal bridge, 1.5% with blepharophimosis syndrome, 1.5% with hypertelorism and 1.5% with telecanthus. Average retinoscopy was +1.39±1.37D for the right eye and +1.43±1.43D for the left eye. True strabismus was detected in 12% (eight cases) at an average 12.63±6.35 months. The mean angle was 21.5±10.5PD. Seven were esotropia and one case of exotropia. Refraction was not found to be a risk factor for development of strabismus. Binocular single vision and best corrected visual acuity were the most important risk factors. The authors recommend follow-up in patients with low visual acuity or sub-optimal BSV where pseudostrabismus is initially diagnosed.
Pseudostrabismus leading to strabismus
Reviewed by Fiona Rowe
Development of strabismus in children initially diagnosed with pseudostrabismus.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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