Abstract

Background: The aim of this study is to report the geometric range of angle kappa formation in patients with and without strabismus. Patients and Methods: This is a retrospective study of three patients with angle kappa in different planes. Routine eye examinations, including visual acuity, slit-lamp examination, and ophthalmoscopy, were performed. A thorough orthoptic examination revealed a notable difference between the prism and alternate-cover test and the Hirschberg measurements. Results: The first patient exhibited a bilateral vertical angle kappa into opposite directions due to retinochoroidal scars. Two other patients presented with horizontal angle kappa deviations. In one patient a true accommodative esotropia was exaggerated by a right negative angle kappa. The other patient had a pseudoexotropia due to bilateral positive angle kappa. Macular ectopia was noted in all cases. Conclusions: The patients herein reported demonstrate a marked variability of angle kappa occurrence in the horizontal and vertical plane. The angle kappa can exaggerate or conceal the size of the true heterotropia.