Pseudoexotropia and Ectopic Macula

Seo, Jin Su; Kim, Seong Ju; Park, Yeoung Geol

Abstract

Ectopic macula is a condition in which the macula is displaced markedly from its normal position. It can be unilateral or bilateral, and the macula can be displaced in any direction, though it is displaced temporally in more than 90% cases. The occurrence of small variation of the position of the macula in relation to the pupillary axis of the eye is evidenced by the variability of the angle K. The most common cause of ectopic macula is probably retinopathy of prematurity and other causes are trauma, chorioretinitis, and angioma. The authors experienced six patients who had ectopic macula. They presented apparent exptropia on Hirschberg test, but no fixation movement on cover test. Fundus examination showed temporal displacement of macula and traction vessel. Pseudoexotropia result from positive angle kappa. It is dangerous to measure the deviation amount by only Hirschberg test or Krimsky test for the uncooperated young patients who have history of prematurity especially. We must check the fundus photographs. With regards to cosmetic surery, each case must be handled individually. Evaluation should include age, visual acuity, the status of binocular vision, and the angle of squint.