Summary about Disease
Esotropia is a form of strabismus (misalignment of the eyes) characterized by one or both eyes turning inward, toward the nose. It's commonly referred to as "crossed eyes." It can be constant (present all the time) or intermittent (occurring occasionally). Esotropia can affect people of all ages, but it's most often diagnosed in infants and young children. Early diagnosis and treatment are important to prevent vision problems like amblyopia ("lazy eye") and double vision.
Symptoms
One or both eyes turning inward.
Squinting or closing one eye, especially in bright light.
Tilting or turning the head to see properly.
Double vision (diplopia), although this is less common in young children who may suppress the vision in one eye.
Decreased depth perception.
Eye strain or headaches.
Causes
The causes of esotropia are varied and can be complex. They include:
Refractive error: Uncorrected hyperopia (farsightedness) is a common cause, as the eye may overfocus to compensate, leading to inward turning.
Muscle imbalance: Problems with the muscles that control eye movement, or the nerves that control those muscles, can lead to esotropia.
Brain abnormalities: In some cases, esotropia can be caused by neurological problems.
Genetics: There is a genetic predisposition to strabismus.
Accommodative esotropia: Related to the focusing effort of the eye.
Congenital esotropia: Present at or shortly after birth, often with no identifiable underlying cause.
Medicine Used
Eyeglasses: Prescribed to correct refractive errors, particularly hyperopia, which can reduce or eliminate accommodative esotropia.
Eye drops (Miotics): In some cases, eye drops like pilocarpine may be used to constrict the pupil and help align the eyes, but this is less common.
Botulinum toxin (Botox) injections: Injected into the eye muscles to weaken them temporarily and help align the eyes. This is often used as a temporary measure or as an alternative to surgery.
Is Communicable
No, esotropia is not communicable. It is not caused by an infection and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent esotropia, as it is often caused by underlying anatomical or neurological factors. Early detection and treatment are crucial. Parents should ensure their children have regular eye exams, especially if there is a family history of strabismus or amblyopia.
How long does an outbreak last?
Esotropia is not an outbreak. It is a chronic condition that, if untreated, can persist indefinitely. Treatment duration varies depending on the cause and severity of the esotropia. Intermittent esotropia may have periods of being more or less noticeable.
How is it diagnosed?
Esotropia is diagnosed through a comprehensive eye examination performed by an ophthalmologist or optometrist. The exam includes:
Visual acuity testing: Measures how well the patient can see.
Refraction: Determines the presence and degree of refractive errors (e.g., hyperopia).
Eye movement testing: Assesses the range and coordination of eye movements.
Cover test: Observes how the eyes move when one eye is covered and then uncovered. This helps detect misalignment.
Prism measurements: Uses prisms to quantify the degree of eye misalignment.
Retinal examination: Checks for any underlying eye conditions.
Timeline of Symptoms
Congenital esotropia: Present at birth or shortly after.
Accommodative esotropia: Typically develops between 2 and 5 years of age, often coinciding with the age when children begin to read and do close work.
Intermittent esotropia: May appear sporadically, often triggered by fatigue, illness, or close work. Symptoms may worsen over time if not treated.
Acquired esotropia (later in life): Onset varies depending on the underlying cause (e.g., neurological conditions).
Important Considerations
Early intervention is key: The earlier esotropia is diagnosed and treated, the better the chances of restoring normal vision and preventing amblyopia.
Amblyopia treatment: If amblyopia is present, it must be treated concurrently with esotropia treatment. This may involve patching the stronger eye to force the weaker eye to work.
Surgery: Eye muscle surgery is often necessary to realign the eyes, especially in cases of congenital or large-angle esotropia.
Long-term follow-up: Regular eye exams are important to monitor eye alignment and vision, even after treatment.
Binocular vision: The goal of treatment is to achieve and maintain good binocular vision (the ability to use both eyes together).
Psychosocial impact: Esotropia can have a significant impact on self-esteem and social interactions, especially in children. Addressing these issues is an important part of overall care.