Early alignment of the eyes allows for the development of brain to eye communication which results in enhanced depth perception, fine motor skills, and the best opportunity to maintain good eye alignment throughout life. Even after successful surgery, close follow-up is necessary to detect associated eye problems. Vertical misalignments of the eye, especially when looking to the side, recurrent eye crossing and amblyopia may occur several months or years later. Despite successful surgical correction of congenital esotropia, this child developed a vertical imbalance of the eyes on both right and left gaze. Acquired Esotropia Esotropia can occur after infancy and not be responsive to farsighted glasses, thereby not falling into the categories of congenital or accommodative esotropia which are described elsewhere on this web site.
Acquired esotropia can have multiple causes.
Most common are children who have been farsighted for awhile and have not had glasses, or children who were initially responsive to glasses but later developed an additional eye crossing even with the proper glasses. All children with acquired eye crossing require a prompt evaluation by a pediatric ophthalmologist. Eye muscle surgery can correct such deviations and restoration of binocular vision is often possible.