Esotropia - causes, symptoms and treatment Esotropia DICTIONARY EYESIGHT INFO FOOD 4 EYES What is Esotropia Esotropia, a form of Strabismus , is the inward deviation (turn) of an eye and occurs in 1.2% of children by 7 years of age and occurs equally in males and females. In esotropia, one or both eyes turn in while in exotropia one or both eyes turn out. Pseudoesotropia refers to the appearance of crossed eyes in a child whose eyes are actually perfectly aligned in relation to each other. This is common in infants and younger children who have a broad, flat bridge of the nose which allows the skin on the inner part of the eyelids to extend over and cover the inner part of the eye. The sclera (the white part of the eye) closest to the nose becomes partially covered, especially when the child looks toward either side, and a crossed eye appearance is simulated. As the face matures and the nasal bones grow, the skin is pulled forward and away from the eye, thereby eliminating the crossed eye appearance.

Congenital Esotropia "Congenital" means from birth and, using this strict definition, most infants are born with eyes that are not aligned at birth. Only 23% of infants are born with straight eyes. In the majority of cases, one eye or the other actually turns outward during the neonatal period. Within the first three months the eyes gradually come into more consistent alignment as coordination of the two eyes together as a team develops. True congenital esotropia is an inward turn of a large amount, and is present in very few children, but the infant will not grow out of this turn. True infantile esotropia usually appears between the ages of 2 and 4 months. Infantile Esotropia The baby with infantile esotropia usually cross fixates, which means that he or she uses either eye to look in the opposite direction. The right eye is used to look toward the left side, and the left eye is used to look toward the right side. By definition, they alternate which eye they are looking with. It is possible to help this type of strabismus with non-surgical methods, such as Eyerobics and/or glasses.

Sometimes, clear tape applied to the inner third of each lens (occlusion) can reduce the tendency to turn inward. Prisms may aid alignment if the turn is not too large. Some children who develop strabismus , in which coordination between the two eyes is poor, also have atypical gross motor development patterns. They typically skip the crawling stage with bilateral movements, and go right from creeping to standing. The interplay between gross motor, particularly balance systems (stems (cerebellar and vestibular) and binocular systems (motor control of the two eyes) is evident in the large number of young children with cerebral palsy who have strabismus. If the inward turn of the eye is constant, and of a large amount, surgery may be indicated. Improved alignment may look better cosmetically, but it does not necessarily enable the brain to utilize information from both eyes together. Stereopsis , or two-eyed depth perception, is often poor following surgical treatment. If amblyopia is present (poorer vision in the turned eye), therapy like Eyerobics which includes patching is often required so that the turned eye develops the capacity to see as well as the better eye. It is best to do this before surgery.

The chance of developing binocular vision with surgery alone diminishes with age. Getting the eyes to work together requires time and effort using a proper eye exercise program, but is worth it! What are the symptoms The person's eye or eyes appear to be turning in. The deviation may occur while fixating (looking at) distance objects, near objects or both. See also above. What causes Esotropia The exact cause of the misalignment is not fully understood. Six eye muscles, controlling eye movements, are attached to the outside of each eye. In each eye, two muscles move the eye right and left. The other four muscles move it up or down and control tilting movements. To line up and focus both eyes on a single target, all eye muscles of each eye must be balanced and working together with the corresponding muscles of the opposite eye. In children the misalignment can be due to a variety of causes including maldevelopment of the eye or even tumors. The brain controls the eye muscles, which explains why children with disorders that affect the brain, such as cerebral palsy, Down's syndrome, and brain tumors often have strabismus. Causes in adults can be quite varied and also require prompt medical attention.

Double vision or strabismus can be the first sign of a serious medical condition including stroke, or brain injury. How is Esotropia diagnosed Your child's health care provider will first determine if the child truly has strabismus. If the child has strabismus, a workup will be done to determine the cause. The physical examination will include a detailed examination of the eyes. The patient may be asked to look through a series of prisms to determine the differences between the eyes. The eye muscles will be tested to determine the strength of the extraocular muscles. Tests include: Neurological examination How can Esotropia be treated A natural vision program that restores the proper function of the eye muscles has been very successful. Surgery is often not necessary. As a matter of fact, early surgery has the potential of disturbing the ability of the brain for fusion in the future and can cause a permanent reduction in vision ( amblyopia ). Published success rates are higher for vision therapy than surgery.

Many surgeons do not advocate vision therapy because they are surgeons and thus like to operate and/or they do not have the facilities to perform vision therapy, and/or have not read the medical literature on vision therapy and unaware of its proven success rates in the treatment of esotropia. Remember, surgery may lessen the work load but it does not reinforce the eyes working together. Many surgical patients have their strabismus come back in the future. Many surgical patients have multiple surgeries without lasting positive results. Even if you have already had surgery it should be followed up with a Natural Vision Program like Eyerobics to ensure the return of the proper function of the eyes. How can Eyerobics help The Eyerobics program is a program of eye exercises based on the Bates Method. This is a well known method developed by Dr William Bates in the 20's. The eye exercises are designed to address most eye disorders by improving the function of your eye muscles and at the same time relaxing them. Because the focus is on improving your eye muscles this program is very well suited to address esotropia. The problem with esotropia is the different tensions of the eye muscles.

If all muscles would be as strong and tight than it would be impossible for your eye to involuntarily move to one direction. The Eyerobics exercises are designed to address ALL muscles making them all as strong and relaxed. To discover all the advantages of the program, our money-back guarantee and the price, read on ... Esotropia | What is Strabismus What is Strabismus? by Dr. Jeffrey Cooper , Rachel Cooper (no relation), and Dr. Leonard Press, FCOVD, FAAO. © 2001-2016 Esotropia (inward turning of the eyes) Esotropia can be divided into various categories each requiring a different treatment plan; each having a different prognosis. Esotropia Congenital Esotropia "Congenital" means from birth and, using this strict definition, most infants are born with eyes that are not aligned at birth. Only 23% of infants are born with straight eyes. In the majority of cases, one eye or the other actually turns outward during the neonatal period. Within the first three months the eyes gradually come into more consistent alignment as coordination of the two eyes together as a team develops.

It is common for infants to appear as if they have esotropia, or inward turn of the eyes, because the bridge of the nose is not fully developed. This false or simulated appearance of an inward turning is known as epicanthus. As the infant grows, and the bridge narrows so that more of the white of the eyes (sclera) is visible on the inner side, the eyes will appear more normal. True congenital esotropia is an inward turn of a large amount, and is present in very few children, but the infant will not grow out of this turn. True infantile esotropia usually appears between the ages of 2 and 4 months. Infantile Esotropia The baby with infantile esotropia usually cross fixates, which means that he or she uses either eye to look in the opposite direction. The right eye is used to look toward the left side, and the left eye is used to look toward the right side. By definition, they alternate which eye they are looking with. It is more difficult to help this type of strabismus with non-surgical methods, such as Vision Therapy and/or glasses.

Sometimes, clear tape applied to the inner third of each lens (occlusion) can reduce the tendency to turn inward. Prisms may aid alignment if the turn is not too large. Some children who develop strabismus, in which coordination between the two eyes is poor, also have atypical gross motor development patterns. They typically skip the crawling stage with bilateral movements, and go right from creeping to standing. The interplay between gross motor, particularly balance systems (cerebellar and vestibular) and binocular systems (motor control of the two eyes) is also evident in the large number of young children with cerebral palsy who have strabismus. If the inward turn of the eye is constant, and of a large amount, surgery may be indicated. Note, however, that both the parent and surgeon have to be committed to multiple procedures to obtain perfect alignment of the two eyes for the patient. Furthermore, even multiple surgeries or "revisions" may end up yielding cosmetic benefits only. That is, the two eyes might look normal or "straight" to outside observers, but normal two-eyed vision has not been achieved.

Improvement might only be cosmetic as surgery does not necessarily enable the brain to utilize information from both eyes simultaneously (binocular vision), so eye teaming, eye tracking, stereoptic vision and/or 3D depth perception is often poor following surgical treatment. If surgery is undertaken, the best chance for visual success occurs when the surgeon works with a developmental optometrist who is comfortable in prescribing glasses and Optometric Vision Therapy to encourage perfect alignment of the two eyes with proper fusion and eye teaming. Such a model of cooperative care would be similar to the complementary relationship between an orthopedic surgeon and a physical therapist. The chance of developing binocular vision with surgery alone diminishes with age. Older children with infantile esotropia may need both surgical intervention, if the turn is large, and pre- and post-surgical Vision Therapy. Smaller turns can be better treated with Vision Therapy only. Getting the two eyes to work together requires time and effort, but it is worth it! See stories written by or about people who had crossed eyes and went on to develop improved vision as older children or adults with Vision Therapy (either after or without surgery) .

Esotropia with Amblyopia (Lazy Eye) If Amblyopia is present," therapy including eye patching is often required so that the turned "lazy" eye develops the capacity to see as well as the preferred eye. If surgery is chosen as a treatment option, it is best to do the lazy eye therapy BEFORE surgery. Accommodative Esotropia If excessive inward turning of an eye is first noted around 2 years of age, it may be due to difficulty integrating the focusing (accommodative) system with the eye alignment (binocular) system. Normally when we look across the room or beyond, our eyes are parallel, or straight. However, when we look at things up close, two things happen. We need to converge more (aim both eyes inward at the same time) and we have to input more focus, or accommodate to keep things clear. Children have large amounts of focusing power, and sometimes in getting things clear, inward turning or esotropia results. If the inward turning only occurs up close, as when playing with small objects, making eye contact, coloring, looking at picture books and so forth, the child may just need glasses for near activities to reduce or eliminate the esotropia.

However, if a child is significantly farsighted (hyperopia), an inward turn of the eye may even occur when focusing to look further away, such as television. If the amount of turn is greater at near than far, your optometrist may prescribe a multifocal lens. For children this could be a traditional bifocal with a line, or a form of no-line bifocal or progressive lens. Your optometrist will review with you which is the best option for your child. In addition, Vision Therapy may be of benefit. Accommodative Esotropia should never be treated with surgery. Accommodative Esotropia Accommodative Esotropia with corrective glasses When the eyes are aligned by corrective lenses sometimes the eyes spontaneously begin to work together. Other times, they need help. Remember, the habit of suppressing or turning off one eye or the other was probably developed over a number of years. The eyes have to be trained to work together again and suppression must be eliminated in order to restore normal eye teaming, depth perception, and stereopsis. The eye doctor might have to patch an eye that was suppressed or turned off and/or employ Vision Therapy. Intermittent turns usually do not require long term treatment.

Vision Therapy may be necessary to improve the muscle coordination and eventually eliminate the bifocal. Patients with Accommodative Esotropia should never have eye muscle surgery to eliminate the need for glasses. If they do, they will have significant focusing problems when they get older. In the future, these patients might be excellent candidates for refractive surgery (hyperopic LASIX) or contact lenses. This should be coordinated with the developmental Optometrist and LASIK surgeon. Partially Accommodative Esotropia In some instances, part of the inward turn is due to basic esotropia, and an additional amount due to the effect of accommodation. Glasses may reduce the amount of eye turn, but it is not totally compensated. Initially, the eye doctor may prescribe prism to compensate for the amount of turn. Office-based Vision Therapy is usually needed. Surgery remains an option to address the non-accommodative portion of the esotropia. Remember that surgery alone rarely enables a patient to learn how to use both eyes together as a team, and usually leaves the patient with poor stereopsis.

Because vision is a learned process, some form of therapy is often helpful in learning new binocular vision patterns, or restoring normal pathways that have been lost or underutilized. Binocular vision occurs in the visual centers of the brain, not in the eye muscles. Successful Treatment Born with congenital esotropia, Susan Barry had three surgeries as a child, but the results were only cosmetic. Her eyes appeared straight but she did not have normal vision. Due to poor vision, Sue had problems learning to read in school, was put in a class of problem children, and had a hard time learning to drive. When Ms. Barry was 48 years old, she did supervised vision therapy with an optometrist and gained the ability to see the world in three-dimensional depth (two-eyed depth perception). Find out more about Sue Barry's book Fixing My Gaze, and other people who overcame eye problems with vision therapy . Accommodative Esotropia — AAPOS Accommodative esotropia, or refractive esotropia, is one of the most common forms of strabismus ( crossed eye). It refers to eye crossing that is caused by the focusing efforts of the eyes as they try to see clearly.

Patients with refractive esotropia are typically farsighted (hyperopic). This means that the eyes must work harder to see clearly, particularly when the object of regard is up close. This focusing effort is called accommodation. The closer an object is to the eye, the greater the amount of accommodation that is required. A side effect of the accommodative effort can be excess convergence or crossing of the eyes. Why is accommodative esotropia a concern in children? If a child’s eyes cross at an early age, then vision will not develop normally. Vision can be permanently reduced in one eye if it is not “used” properly during childhood, and fine depth perception may never develop. If crossing of the eyes is diagnosed and treated early, then vision development can proceed normally. Crossing of the eyes is never normal (except for occasional crossing in the first three months of life), and any child suspected of having crossed eyes should be examined by a pediatric ophthalmologist. Do all children with farsightedness have accommodative esotropia? No, in fact most children are farsighted but the majority of them do not have any esotropia.

Most children are only mildly farsighted, and thus the accommodative effort they make to see clearly is not significant. The more farsighted a person is, however, the greater the amount of effort they must exert and the more likely they are to cross their eyes. Therefore, while two individuals may have the same eye prescription strength, one may have eye crossing and the other may have perfectly straight eyes. Heredity plays a role in determining which children develop esotropia. How is accommodative esotropia treated? Initial treatment for accommodative esotropia usually involves the prescription of eyeglasses or contact lenses to correct the patient’s refractive error (hyperopia) [See figure 1]. By letting the eyeglasses do the work, the eyes can relax their focusing or accommodative effort. In turn, this will reduce the convergence or crossing stimulus and the eyes will straighten as they relax. Glasses or contacts which are used to treat accommodative esotropia should be worn full time. Fig. 1 Initial treatment for accommodative esotropia usually involves the prescription of eyeglasses or contact lenses to correct the patient’s refractive error (hyperopia).

What happens after a child starts wearing glasses for accommodative esotropia? Even after a child has been successfully wearing glasses to treat accommodative esotropia, it is still normal for the eyes to continue crossing without the glasses. In fact, the crossing may be even more noticeable than it was before the child started wearing glasses. The important thing is whether the eyes are straight and controlled with the glasses on. If the eyes are not straight with glasses on, then vision with two eyes will not develop normally. Your pediatric ophthalmologist is the best person to judge this and will give you feedback at follow-up examinations. These follow-up examinations are important not only to monitor the eye crossing, but also to check for associated problems such as amblyopia (decreased vision in one or both eyes which is common in this type of strabismus). What role does surgery play in accommodative esotropia? Surgery is indicated only if the eyeglasses fail to straighten the eyes while the glasses are on. In this case, eye muscle surgery (strabismus surgery) may be recommended to help improve eye alignment.. This surgery is usually done in childhood to help promote binocular vision development.

Usually surgery for accommodative esotropia does not eliminate the need for glasses, but rather fixes the amount of crossing that is “left-over” when the glasses are on. The eyes will likely continue to cross when the glasses are off. Why do some children with accommodative esotropia require bifocals? In some cases, children will have particularly excessive amounts of eye crossing (esotropia) at near, such as while reading. This may occur even when wearing the correct glasses to correct their farsightedness (hyperopia) and they may have perfectly straight eyes when looking at distant objects. These children may benefit from making the lower, reading area of the eyeglasses “extra strong” in the form of a bifocal lens. Can children outgrow accommodative esotropia? Yes, children can outgrow accommodative esotropia. This usually happens during the grade school and adolescent years as a child becomes less farsighted. It is difficult to predict early in childhood whether or not any given child will outgrow their need for glasses. Updated 03/2015 REFERENCES Glossary (still in progress) Accommodation: The process of focusing our eyes to make targets clear at different distsances.

Accommodation works with vergence; it is a neuromuscular process. This visual skill regulates the focus of the eyes at different distances. To accommodate for clear vision at various distances the lens in our eye actually changes shape. The somewhat gelatinous material of the lens is “stretched” or “squashed” due to muscle actions within the eye, this change in shape changes the power of the lens. A camera lens that can zoom in and out simulates this idea. Accommodation Excess: A diagnosis made by the doctor when a focusing system is overactive, uses more power than necessary and stay stimulated even when stimulus is absent. A person with this condition exerts too much power when working on near tasks. Accommodation Insufficiency: A diagnosis made by the doctor when the focusing system is underactive, or does not supply enough power to provide a clear image at a particular distance and will have trouble switching focus easily between distances, particularly far to near and vice versa.

Accommodation Posture:The measured distance ahead of or behind the object of regard where the focusing system "rests." If this posture is either closer than the object or farther than the object, such as a book, the visual system must work harder to keep the object clear. Amblyopia: Low or reduced visual acuity not correctable by refractive means, (glasses or contacts) and exists despite any apparent structural or pathologic abnormalities of the eye. Amblyopes often are strabismic (exotropic or esotropic). A common lay term for amblyopia is “lazy eye,” and should be a diagnosis of exclusion of other causes of reduces clarity of sight. Ammetropia: Having a refractive error. Astigmatism: Astigmatism nearly always refers to the shape of the front of the eye, the cornea (occasionally astigmatism exists in the lens of the eye).

A spherical cornea has no astigmatism, a cornea shaped more like the bowl of a spoon distorts images, the light rays are being bent and focused at more than one spot creating a less than clear image, the image appears to have a haze surrounding it, or a “ghost image.” Binocular: If a person uses both eyes together they see binocularly. Binocular vision allows us to see depth and dimension, people lacking good binocular vision are unable see the images in the “magic pictures.” Double vision can be a consequence of poor binocularity, sometimes the person will, unconciously, simply shut down one eye to avoid seeing double. Esotropia: An esotropic eye turns inward toward the nose. This eye turn may be evident all the time or only when a person is fatigued and may be subtle enough that only a trained eye professional will detect the turn. The eye turn may be related to a high refractive error, a muscle or nerve weakness or occasionally a muscle trapped against a bone. Exotropia: An eye that turns outward toward the temple.

This eye turn may be evident all the time or only when a person is fatigued and may be subtle enough that only a trained eye professional will detect the turn. The eye turn may be related to a high refractive error, a muscle or nerve weakness or occasionally a muscle trapped against a bone. Eyesight: The ability to see light, a sense that most of us are born with. SEE: VISION Fovea: The fovea located on the retina of the eye is the point from which we see most sharply and where the receptors are located that allow us to see colors. In a normal visual system the fovea of the left and right eye are directed at the same point in space at the same time giving us a better image than either eye alone. Hyperopia: Farsightedness, a farsighted person often has good vision at near and far distances, however the persons eyes are naturally focused in the distance and so a lot of extra effort is needed to bring near objects into focus, for example the work a student does at their desk. This translates to eye fatigue, headaches and often, poor ability to stay on task.

Myopia: Nearsightedness, a myopic person has good vision at near but cannot see well far away. Refractive Error: This term is typically used to describe eye problems that can be remedied with glasses or contact lenses. Lens powers are found during the eye exam that will, when combined with the eyes own power, converge parallel rays of light onto the retina to create the best image possible. Myopia, hyperopia, and astigmatism are common problems of refractive error. Strabismus: The patient cannot fixate/foveate an object binocularly under normal conditions. That is, the person cannot keep both eyes directed at the same point in space, the person is exotropic or esotropic. Vergence: Vergence works in combination with accommodation, it is the skill that regulates where in the plane of regard we are aiming our eyes so that we see single and not double images. Convergence implies both eyes are turning medially, toward the nose, in the case of divergence both eyes are moving outward toward the temples. Vision: Vision is a learned, dynamic (or changing) process of organizing, interpreting and understanding what is seen.

It is a process that integrates sensory and motor information generated by the brain and body to derive meaning and direct movement. SEE: EYESIGHT Esotropia — Signs, Causes, and Treatment Dr. Trent Albright Commonly referred to as crossed eyes, esotropia is a common type of strabismus in which one or both eyes turn inward toward the nose. It is most often identified in children between the ages of 2 and 4, although it can occur at any age. The opposite of esotropia is exotropia , which is characterized by eyes that point outward, toward the ears. The degree of esotropia may vary from small-angle (hardly noticeable) to large-angle (very noticeable), and the condition may be characterized as congenital (meaning that the affected person is born with it) or acquired. What Are The Signs and Symptoms of Esotropia? The primary sign of esotropia, obviously, is crossing of the eyes. Habitual squinting or constantly rubbing one eye are also common signs. If your child suffers from this condition, he or she may also complain of double vision . Crossed eyes can be constant or intermittent.

A constant esotropia is present all the time, whereas intermittent esotropia may become apparent only when looking at close objects or only when looking at distant objects, or if the affected person is tired or sick. Intermittent esotropia often requires treatment to prevent it from becoming constant. As indicated above, esotropia is either congenital or acquired. Congenital esotropia (also known as infantile esotropia) is usually detected during the first six months of life. Infants with esotropia are otherwise developmentally and neurologically normal. Acquired (or secondary) esotropia, which develops later in life, can occur for a variety of reasons: Accommodative esotropia is eye crossing that results from the focusing efforts of the eyes. It is the most common form of esotropia in children, and it is caused by uncorrected farsightedness (also known as hyperopia ). The eyes cross when they converge in an attempt to focus. In accommodative esotropia, the eye crossing may only be evident when your child stares intently at a near object, or when your child is tired or not feeling well.

Correcting the hyperopic refractive error with eyeglasses will usually fix the deviation. Non-accommodative esotropia is often associated with an underlying disorder. Early surgical correction appears to benefit children with this condition more than vision correction with eyeglasses. Acute esotropia is the sudden development of crossed eyes from no apparent reason in a school-aged or older child with previously normal vision. Immediate evaluation of the child with acute esotropia is necessary to determine the underlying cause. Among the possible causes are a few potentially life-threatening conditions such as meningitis, encephalitis, and head trauma. Mechanical esotropia is caused by a problem with the intraocular muscles. The intraocular muscles can become restricted or tightened by disease (like thyroid myopathy, for example), or they may be physically obstructed as a result of a blowout fracture (a blowout fracture is a fracture of the walls of the eye’s orbit—in layman’s terms, the eye sockets in the skull). Mechanical esotropia may be seen in children with Duane syndrome , an eye muscle disorder that can prevent outward movement of the eye (toward the ear).

Sensory esotropia: A person with this condition suffers from reduced visual acuity in one eye, which hinders or disrupts the process of fusion in normal binocular vision (binocular vision is the coordination of both eyes so that the separate and slightly dissimilar images seen by each eye are appreciated as a single image). Sensory esotropia occurs most frequently in children younger than 5 or 6. Consecutive esotropia: This may occur after surgical overcorrection of an exotropia. Consecutive esotropia may result in a condition called amblyopia (lazy eye) and loss of normal binocular vision in young children and diplopia (double vision) in adults. What Causes Esotropia? Crossed eyes can be hereditary, although it may occur differently in different family members. It is also associated with prematurity and various neurological and genetic disorders. Farsightedness is the most common vision problem associated with esotropia. Some systemic disorders, such as hyperthyroidism and diabetes, cause ocular misalignment.

The appearance of crossed eyes in an infant is not always a sign of esotropia; it can be a result of the shape of the eyelids or nasal bridge, and as the infant grows, the misalignment goes away. This is called pseudostrabismus. How Is Esotropia Diagnosed? Infants and children with suspected esotropia are typically evaluated by a pediatric ophthalmologist or optometrist, who will review the child’s medical and family histories and then perform an examination to determine the child’s visual acuity. This includes an evaluation of the general health of the eyes and their refractive state (that is, whether the child is farsighted, nearsighted , or has astigmatism ). The eyes will be dilated with eye drops to determine the degree of farsightedness. The ophthalmologist or optometrist will pay close attention to whether the acuity is equal in both eyes or if one eye is stronger than the other. If there is a strong preference for one eye over the other, amblyopia may occur. Amblyopia occurs when one eye fails to properly communicate visual images to the brain, and it is best treated at an early age.

It can sometimes be treated by patching the stronger eye, but in some cases more aggressive methods of treatment are necessary. If ocular misalignment is detected, the degree of misalignment is measured so that the child can be fitted with the appropriate glasses. How is Esotropia Treated? Initial treatment of esotropia may involve the prescription of eyeglasses or contact lenses to correct the child’s farsightedness. Glasses should be worn all the time. Children whose eyes cross even when they are wearing glasses or contact lenses may benefit from a bifocal lens. Surgery is rarely necessary, but may be considered if eye glasses fail to straighten the eyes. Surgery does not eliminate the need for glasses; it simply reduces the degree of eye crossing. The goals of treatment are to re-establish ocular alignment, maximize binocular vision, relieve any double vision, and manage any associated amblyopia. If amblyopia is present and surgery is being considered, it is best to address the amblyopia with eye-patch therapy before surgery is performed. What Can I Do To Prevent Esotropia From Developing?

Esotropia cannot be prevented, but complications resulting from it can be prevented if the problem is detected early and treated properly. Children should be monitored closely during infancy and through the preschool years to detect potential eye problems, especially if a relative has strabismus. In the United States, children are typically screened for eye health before they are six months old, and thereafter at each check-up with their pediatrician or family practitioner. A thorough eye examination by an ophthalmologist or optometrist is recommended when the child is between the ages of 3 and 5. References: American Optometric Association, Optometric Clinical Practice Guideline. “Care of the Patient with Strabismus: Esotropia and Exotropia,” 2011. American Association for Pediatric Ophthalmology and Strabismus, “Esotropia,” Updated March 2012. B. G. Mohney. “Acquired nonaccommodative esotropia in childhood.” Journal of the American Association for Pediatric Ophthalmology and Strabismus. 2001;5(2):85-89. A. E. Greenberg, B. G. Mohney, N. N.

Diehl, J. P. Burke. “Incidence and types of childhood esotropia: a population-based study.” Ophthalmology. 2007;114(1):170-174. This article was last updated on 09/2015 Eye Diseases & Conditions: Lazy Eyes - Alternating Exotropia Strabismus - YouTube Lazy Eyes - Alternating Exotropia Strabismus Want to watch this again later? Sign in to add this video to a playlist. Need to report the video? Sign in to report inappropriate content. Rating is available when the video has been rented. This feature is not available right now. Please try again later. Uploaded on Oct 11, 2007 I have congenital Alternating Exotropia Strabismus, where my eyes tend to wander outward, one at a time. I see clearer when I use just one eye like when reading a street sign or watching tv, but I have to use both when driving so I have some depth perception. I wore an eye patch as a kid for a short time, but it didn't help.

Upside: I can see those 3D Magic Eye images pretty quickly and I can freak people out, which is fun. Downside: I don't have the best depth perception and sometimes have a hard time keeping them straight when I'm very tired. Song used in the video: "So Much Beauty in Dirt" by Modest Mouse - - - - - - - - - - - - - - - - - - - Congenital Strabismus: The person was born with it Acquired Strabismus: The person developed it later in life WHICH EYES WANDER: Bilateral Strabismus: Both eyes wander at the same time Unilateral Strabismus: Only one eye repeatedly wanders Alternating Strabismus: Both eyes wander but not at the same time DIRECTION OF MOVEMENT: Esotropic Strabismus: The eye wanders inward Exotropic Strabismus: The eye wanders outward Hypertropic Strabismus: The eye wanders vertically Pseudostrabismus: Is false. It looks like they have strabisumus, but they just have a wide flat bridge of the nose that makes it appear as though they are slightly cross-eyed.

Amblyopia: Or known as lazy eye, this is usually when a person has such bad vision in one eye that they no longer use it and they only use the good eye when focusing. The eye will eventually lose strength so it permanently wanders and often times will lose vision too. Category Exotropia - EyeWiki Exotropia Assigned status Update Pending by A. Paula Grigorian, MD on January 22, 2015. {| cellspacing="5" Sensory Exotropia[ edit | edit source ] A blind or poorly seeing eye may drift outward. Infants or young children with a blind or poorly seeing eye usually develop esotropia (cross-eyes), but in children older than 2-4 years of age and adults, the eye will typically become exotropic. Etiology[ edit | edit source ] The etiology of exotropia is unknown, but on a rudimentary level there is impaired ability to maintain fusion and alignment. In the case of sensory exotropia, the poor acuity of one eye is the cause of the inability to maintain alignment.

General Pathology[ edit | edit source ] Intermittent exotropia, the most common type of exotropia, has a usual onset between infancy and 7 years of age. There is no specific refractive error associated with exotropia. Although there is no specific racial predilection, Asians with strabismus are more often exotropic when compared to other racial groups. Intermittent exotropia[ edit | edit source ] Is an intermittent deviation which is more likely to be manifest when fatigued, ill, or in a lowered mental state (ex. ETOH use). It is more commonly manifest with distance fixation and also in bright sunlight. Types of intermittent exotropia: Basic- distance and near deviations are within 10 prism diopters (units of measurement) of each other. These patients have normal convergence. Pseudo-divergence excess- a larger exotropia is present for distance, but this difference is extinguished after 30-60 minutes of monocular occlusion. These patients have increased tonic fusional convergence. True divergence excess- a larger exotropia is present for distance, even after 30-60 minutes of monocular occlusion.

More than ½ of these patients have a high AC/A ratio and are prone to postoperative overcorrections if operated on for their full distance deviation. Nonsurgical[ edit | edit source ] Effectiveness of these therapies varies and in some cases they are only temporizing. Nonsurgical treatments include: patching, over-minused spectacles, and convergence exercises (for convergence insufficiency). Prism glasses can be used to relieve diplopic complaints or asthenopia. Also some cases of exotropia may be improved by treating an underlying visual disturbance (ex. Cataract, refractive error, amblyopia) Surgical[ edit | edit source ] Performed to preserve or restore binocular function. Also may be performed for relief of diplopia and/or cosmesis. In general, long-term surgical success is better if the exotropia is intermittent instead of constant and the patient has better binocular function at the time of surgery. There is controversy as to the optimal time for surgical intervention. Surgery consists of operating on the extraocular muscles.

Question: If a person is Esotropic, they are what?
Answer: Cross-eyed