The aim of this study was to assess whether OCT could be useful in detecting and documenting fixation in children with microtropia. The study used spectral domain OCT (Cirrus) in 15 patients (10 female, five male) and 10 control eyes. The average age of patients was 8.86±2.6 years. The left eye was microtropic in 73% with amblyopia. Microtropia was evident on cover test in 67% but ortho in the remainder. No stereopsis was measured and a central scotoma was present in all cases on 4PD base-out test. Spherical equivalent refraction was +3.60±2.74 in the amblyopia eye and +2.71±2.35 in the fellow eye. Thirteen percent had no anisometropia. Best corrected visual acuity was 0.03 in the fellow eye and 0.18 in the amblyopic eye. Eccentric fixation was noted on OCT of 387±199um in the amblyopic eye. Superonasal eccentricity was most frequent in 57%, then nasal in 29% and inferonasal in 14%. The average micro deviation was 3.73±3.34PD. Ortho cases had OCT values of 383±66um versus 439±235um for the microtropic cases. The authors conclude OCT can aid in the detection of eccentric fixation and provide a relative degree of location of the retinal fixation point.