Pseudoamblyopia and excyclodeviation

To demonstrate that congenital cyclodeviations can be the cause of low monocular vision in children that can be resolved by surgically eliminating the deviation. In this retrospective observational study 8 consecutive children undergone inferior oblique muscle recession for congenital superior oblique palsy were involved. Mean BCVA of the deviated eye was 0,38 before surgery and 0,9 soon after surgery. Cyclodeviations are characterized by a misalignament of the eyes around the antero-posterior axis. Probably in the early years of life patients may have normal binocular vision with bi-foveal fixation and absence of amblyopia. Then the stress pattern caused by cyclotorsion may induce a displacement of the fixation point in the cyclodeviated eye causing low monocular vision and depressed binocular functions. This sensorial condition may be reversible and early surgery may restore immediately normal binocular vision and normal monocular visual acuity. Then in congenital superior oblique palsy not a true amblyopia is present but low vision from altered fixation and associated suppression.