A 3-year-old child is noted to have the right eye deviating inward. Cover test reveals that covering the right eye causes an outward movement of the left eye, and uncovering the right eye causes the right eye to move inward again. The child fixes with the left eye. This is best described as:

• A Alternating esotropia
• B Right esotropia with left eye fixation preference ✓
• C Pseudostrabismus from epicanthal folds
• D Right exotropia with intermittent suppression

Explanation

The cover test findings describe a right esotropia (inward deviation of the right eye) with fixation preference for the left eye. When the fixing left eye is covered, the deviating right eye must take up fixation (moves outward from its deviated position to straight). This child is at high risk for developing amblyopia in the right eye due to constant suppression; treatment involves correction of any refractive error, patching of the preferred eye, and surgical correction of the angle if needed.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.