Esotropia

What is esotropia?

Strabismus is a condition that is characterized by the misalignment of the eyes. The most common form of strabismus in infants is Esotropia. Esotropia can be characterized by one eye deviating inward to the nose and the other eye fixating itself properly. If the eye is deviating outward then the condition is called exotropia. Four percent of children in the United Kingdom suffer from strabismus. This condition is also known as cross-eye. Males and females are equally afflicted with this. Strabismus is also a condition that is known to be hereditary. Moreover, this condition can affect teenagers, adults, people with diabetes, who have gone through a stroke or a brain injury, and people with high blood pressure.

If your eyes are properly aligned, your brain can see objects three dimensionally. Proper alignment of both eyes will produce the proper image in the brain. The images from each eye will be fused together to form one coherent image. People with strabismus aren’t able to produce one coherent image. When one of the eyes is turning outward, inward, downward, or upward, two different images are sent to the brain which will result in the inability to perceive depth properly. Binocular vision also results from strabismus.

The occurrence of esotropia

There is such a thing call pseudoesotropia or false esotropia. This is when there is a physical appearance of cross-eye despite perfect alignment. This is usually seen in some infants because of their wide, flat noses and folds of skin at the inner eyelid. This gives the appearance of cross eye and will eventually go away as the infant grows up.

During the first six months of an infant, congenital or infant esotropia can be present already. It is normal for an infant’s eyes to be misaligned during the first few months although if the condition is still evident after the first few months then the child must be checked by a physician already. About two percent of children have congenital esotropia and this condition does not become better as they grow up. The child may need to go through surgery in order to fix the problem. Surgery is advised between six to fourteen months old.

For children who are in their toddler years, from two onwards, accommodative esotropia can occur especially with children who have farsightedness. Farsightedness can be overcome by practicing focus although this may cause the eyes to cross. In order to reduce this effort of focusing, eyeglasses can be used. They can straighten the eyes.

Some eyedrops, ointments, and prism lenses can be used to address esotropia in children. There are also some eye exercises that can help in focusing for the older children. There are also bifocals that can be used for correcting the excessive turning of the eyes.

There is a condition called acquired esotropia and happens after the infancy stages. The children that are most affected here are those who are farsighted without glasses or those who had glasses and developed an eye crossing later on. In order to correct this disorder, children must go through an evaluation immediately.

There are forms of esotropia that aren’t completely understood nowadays. The basic knowledge relating to eye movement pertains to the six muscles that are responsible for motion. There are four muscles that move your eyes upwards and downwards and there are two muscles that move it from left to right. If these muscles are working properly then the brain will be able to see a single image but if there are malfunctions in these muscles then strabismus can be evident. Strabismus is common in children with brain disorders like Down’s syndrome, hydrocephalus, cerebral palsy, and tumours in the brain.

What are some of the symptoms of esotropia?

Some of the symptoms of esotropia include a decrease in one’s vision, the misalignment of the eyes, and double vision. Children who have esotropia are unable to use both of their eyes at in unison. Most of the time, they will squint in bright daylight or they will tilt their heads at a certain angle in order to use both of their eyes. Most of the time, they will also rub their eyes. Children will not tell you that they are experiencing double vision. Instead, they will simply close one of their eyes in order to make up for problems of the other eye. You will also observe that children with esotropia have problems perceiving depth.

Children with strabismus may develop complications with their brain. Their brain could adapt to the misaligned eye by ignoring it and only using the other eye which is functioning properly. This will lead to a lazy eye or what doctors call amblyopia. The children will lose their ability to perceive depth. For adults who acquire strabismus, double vision usually results. This is because the brain is used to processing images from both eyes and can no longer ignore the images from the affected eye.

How is esotropia treated?

Treating esotropia will vary depending on its type. For instance, if the esotropia is accommodative then it can be treated with corrective glasses, putting a patch over the affected eye, or through therapeutic methods. If the esotropia has been acquired or if it is congenital then surgery is required to treat it.

During surgery, an incision will be made on the tissues that cover the eye. This will enable the surgeon to reach the inner eye muscles. The surgeon will do either of two things. The surgeon will move the tight inner muscles backwards in order to make their pull weaker or the surgeon will move the loose outer muscles outwards in order to make them tighter. This surgery is normally done under general anaesthesia. Recovering from the surgery is fast and you can go back to your day-to-day activities after a few days. After the surgery, you may need to wear eyeglasses or you may even have to go to more surgeries in order to maintain straight eyes.

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