Pseudo-strabismus secondary to macular heterotropia: a case report and literature review

Aim: To present a case of pseudo-strabismus secondary to macular heterotropia, caused by retinopathy of prematurity (ROP). An overview is given of the literature on this subject.Methods: The case of a 9-year-old child born prematurely at 26 weeks’ gestation and who had cryotherapy treatment for stage 3 ROP, is reported with reference to her birth history and her ophthalmic, orthoptic and photographic findings.Results: The patient had a pseudo-exotropia resulting from an abnormal shifting of the macula known as macular heterotropia, an abnormal fundus appearance found in ROP, especially in eyes treated with cryotherapy. Macular heterotropia has been reported in conditions such as retinal tear, idiopathic retinal folds, persistent hyaloid vessels, chorioretinal coloboma, chorioretinisis, Toxocara canis, vitreous structural anomalies, and very high myopia.Conclusions: Orthoptists should be aware of the features of macular heterotropia and its associations with ROP and pseudo-strabismus.

Abstract licence: CC BY

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