A common misconception is that children with cross-eye (esotropia) outgrow the condition, but this is generally not the case. This belief stems from confusion between true strabismus and what is known as pseudostrabismus, or false strabismus.

Figure 41-14 Cover-uncover test. Evaluate the unoccluded eye for strabismus. (From AAO. The Child's Eye.)

A child with pseudostrabismus has broad folds of skin that partially cover the top of each eye and a flat nasal bridge that creates the illusion of crossed eyes. As the child ages and the skin fold becomes less apparent, the condition becomes less noticeable. When a child's eyes are truly crossed, it is always a serious condition and requires the care of an ophthalmologist.

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