During the examination of a 4-year-old child, the corneal light reflex is found at the temporal pupillary border in the right eye. This indicates:
- A Normal alignment (physiological positive angle kappa) ✓
- B Right exotropia
- C Right hypertropia
- D Right esotropia
Correct answer: A. Normal alignment (physiological positive angle kappa)
Explanation
D positive angle kappa is a normal variant where the fovea is temporal to the pupillary axis, causing the light reflex to appear displaced temporally in both eyes. This is physiological and must be distinguished from esotropia. In true esotropia, the reflex would be displaced temporally only if the eye is deviated inward. D unilateral temporal displacement without actual misalignment on cover test is physiological angle kappa, common in children.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.