{"id":280,"date":"2020-03-26T12:56:37","date_gmt":"2020-03-26T12:56:37","guid":{"rendered":"https:\/\/www.optometrists.org\/wordpress\/?page_id=280"},"modified":"2021-07-15T07:33:42","modified_gmt":"2021-07-15T07:33:42","slug":"esotropia-inward-eye-turn","status":"publish","type":"page","link":"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/esotropia-inward-eye-turn\/","title":{"rendered":"What Is Esotropia?"},"content":{"rendered":"<h2><strong>Esotropia is a form of strabismus (crossed-eyes) that is caused by an <i>inward <\/i>turn of the eye, toward the nose<\/strong>.<\/h2>\n<p>The condition can be <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/strabismus-crossed-eyes\/what-is-intermittent-strabismus\/\">constant or intermittent<\/a> and cause an individual to appear \u201ccross-eyed\u201d.<\/p>\n<p>There are four different forms of esotropia:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Congenital (infantile) esotropia<\/li>\n<li style=\"font-weight: 400;\">Esotropia with amblyopia<\/li>\n<li style=\"font-weight: 400;\">Accommodative esotropia<\/li>\n<li style=\"font-weight: 400;\">Partially accommodative esotropia<\/li>\n<\/ul>\n<h2><b>Does your infant appear crossed-eyed? <\/b><\/h2>\n<p><strong>Only 23 percent of infants are born with eyes that appear perfectly straight and aligned, so there is no need to panic if your newborn appears to have an eye turn!<\/strong><\/p>\n<p>Most infants are born with misaligned eyes, with one eye usually turning outward, appearing \u201ccrossed eyed\u201d.\u00a0<a href=\"https:\/\/www.optometrists.org\/childrens-vision\/guide-to-vision-development\/\">Within the first three months of age,<\/a> the eyes gradually straighten as they begin to develop the neural connections with the brain and work together as a coordinated team.<\/p>\n<p>It is also common for infants to <i>appear <\/i>as if they have esotropia, because the bridge of the nose is not yet fully developed.\u00a0 As the bridge of the nose develops, more of the white of the eyes, the sclera, becomes visible on the nasal side, enabling the eyes to appear more aligned.<\/p>\n<h2><b>Congenital (infantile) esotropia<\/b><\/h2>\n<p>Infantile esotropia is a significant inward turn of one of the eyes during infancy, typically as a result of <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/what-is-long-sightedness\/\">hyperopia (farsightedness).<\/a><\/p>\n<p>This condition usually appears when the infant is between two and four months of age. A baby with infantile esotropia typically looks with one eye, while the other eye looks inward towards the nose, this is called cross fixation.<\/p>\n<p><strong>The primary concern with infantile esotropia is that the condition will inhibit the development of the two eyes to work together as a team\u2014 resulting in either reduced, or complete absence of binocular vision and depth perception.<\/strong><\/p>\n<p>Furthermore, poor eye coordination can lead to atypical gross motor development\u2014 preventing the infant to reach important <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/guide-to-vision-development\/\">developmental milestones.<\/a><\/p>\n<p>According to the American Optometric Association (AOA), children who have had significant hyperopia during infancy are at a higher risk of developing strabismus and <a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-lazy-eye\/lazy-eye-faqs\/\">amblyopia (lazy eye)<\/a> by the age of four.\u00a0 Moreover, the presence of anisometropic hyperopia, which is farsightedness with an unequal refractive error in both eyes, <i>further <\/i>increases the risk of the child developing strabismus and amblyopia.<\/p>\n<h2><b>How is infantile esotropia treated?<\/b><\/h2>\n<p>If the infant presents with a <i>constant<\/i>, significant inward eye turn, then <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/strabismus-crossed-eyes\/strabismus-surgery\/\">surgery<\/a> (which may include several procedures) may be required. However, the chance of developing binocular vision with surgery alone diminishes with age.<\/p>\n<p>Therefore, even with multiple surgeries, an older child with infantile esotropia might appear as if his eyes are aligned, but normal binocular vision has likely not been achieved.<\/p>\n<p><strong>In this case, <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-faqs\/\">vision therapy<\/a> to improve eye teaming, eye tracking, stereoscopic vision, and 3D depth perception should be provided.<\/strong><\/p>\n<p>In less severe cases, eye doctors may recommend <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/neuro-optometry\/what-are-prism-lenses\/\">prisms<\/a>, eyeglasses, or occlusion (taping the inner third of eyeglass lenses) to reduce the tendency of the eye to turn inward. Additionally, vision therapy may be recommended to treat the underlying causes of the eye turn.<\/p>\n<p><a href=\"https:\/\/www.optometrists.org\/practice-search\/\"><strong>Schedule an exam<\/strong><\/a> with a vision therapy eye doctor and to start improving your child&#8217;s vision.<\/p>\n<p><strong>SEE RELATED:<\/strong> <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/what-is-accommodative-esotropia\/\">What Is Accommodative Esotropia?<\/a><\/p>\n\n\t<div class=\"practice-search-widget\">\n\t\t<h3>Find an eye doctor for children near you<\/h3>\n\t\t\n\t<form class=\"practice-search-form practice-search-form-widget\" action=\"https:\/\/www.optometrists.org\/practice-search\/results\/\" method=\"get\">\n\n\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\t\t<input type=\"hidden\" name=\"page\" class=\"practice-search-page\">\n\t\t<input type=\"hidden\" name=\"address_latitude\"><input type=\"hidden\" name=\"address_longitude\">\n\n\t\t<input type=\"text\" name=\"address\" class=\"practice-search-address\" placeholder=\"City, Surburb or Address\" value=\"\">\n\n\t\t\n\t\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\n\t\t\n\n\t\t<button type=\"submit\" class=\"practice-search-button\">\n\t\t\t\t\t\t\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M10.6796 0.130005C9.15708 0.130059 7.66615 0.5646 6.38198 1.38258C5.09781 2.20057 4.07373 3.36803 3.43004 4.74783C2.78634 6.12763 2.54976 7.66246 2.74808 9.17205C2.9464 10.6816 3.57139 12.1033 4.54964 13.27L0.729639 17.08C0.6364 17.1732 0.562439 17.2839 0.511979 17.4058C0.461519 17.5276 0.435547 17.6581 0.435547 17.79C0.435547 17.9219 0.461519 18.0524 0.511979 18.1743C0.562439 18.2961 0.6364 18.4068 0.729639 18.5C0.917942 18.6883 1.17334 18.7941 1.43964 18.7941C1.5715 18.7941 1.70207 18.7681 1.82389 18.7177C1.94571 18.6672 2.0564 18.5932 2.14964 18.5L5.99964 14.62C7.35406 15.6038 8.98566 16.1324 10.6596 16.13C12.7814 16.13 14.8162 15.2871 16.3165 13.7869C17.8168 12.2866 18.6596 10.2517 18.6596 8.13C18.6596 6.00827 17.8168 3.97344 16.3165 2.47315C14.8162 0.97286 12.7814 0.130005 10.6596 0.130005H10.6796ZM10.6796 14.13C9.49295 14.13 8.33291 13.7781 7.34622 13.1188C6.35952 12.4595 5.59049 11.5225 5.13636 10.4261C4.68224 9.32975 4.56342 8.12335 4.79493 6.95946C5.02644 5.79558 5.59788 4.72648 6.437 3.88736C7.27611 3.04825 8.34521 2.4768 9.5091 2.24529C10.673 2.01378 11.8794 2.1326 12.9757 2.58673C14.0721 3.04085 15.0092 3.80989 15.6685 4.79658C16.3277 5.78328 16.6796 6.94332 16.6796 8.13C16.6796 9.7213 16.0475 11.2474 14.9223 12.3726C13.7971 13.4979 12.2709 14.13 10.6796 14.13Z\" fill=\"#fff\"\/><\/svg>\n\t\t\t\t\t<\/button>\n\n\t\t<button type=\"button\" class=\"practice-search-use-my-location\">\n\t\t\tSearch near me\n\t\t<\/button>\n\n\n\t<\/form>\n\n\n\n\t\t<\/div>\n\n\t\n<h2><b>Esotropia with amblyopia (lazy eye)<\/b><\/h2>\n<p>Children with strabismus and lazy eye must be identified and treated at a young age to increase their chances of restoring normal visual acuity.<\/p>\n<p>Treatment for lazy eye typically involves eye patching of the stronger eye which forces the turned lazy eye to develop greater strength. Surgery (sometimes involving multiple procedures) may be recommended for a significant eye turn to re-align the eyes\u2014 though vision usually remains blurry even after surgeries. For this reason, vision therapy is typically prescribed to treat the visual pathways and reestablish the eye-brain connections.<\/p>\n<h2><b>Accommodative esotropia<\/b><\/h2>\n<p>Clear vision of close objects requires our eyes to converge (aim both eyes inward at the same time) in order to properly focus, or <i>accommodate<\/i>. Too much focusing power may lead to an inward turn of the eyes.\u00a0 If an inward eye turn is only noticed at around two years of age, it may be a result of poor integration of the accommodative system with the eye alignment (binocular) system.<\/p>\n<h3><b>Corrective lenses for treatment of accommodative esotropia\u00a0<\/b><\/h3>\n<p><strong>If the eye turn only occurs when focusing on close objects then wearing glasses for near vision may be effective at reducing or eliminating the esotropia<\/strong>.<\/p>\n<p>In these cases, the eye turn is noticed when the child is playing with small objects, making eye contact, coloring, looking at picture books, and participating in other close vision tasks.<\/p>\n<p>Additionally, if a child is significantly farsighted (hyperopia), an inward turn of the eye may even occur when focusing on distant objects, such as a television. In this case, corrective eyeglasses may be sufficient in treating the esotropia.<\/p>\n<p>A <a href=\"https:\/\/www.optometrists.org\/optical\/guide-to-bifocals-and-multifocals\/\">bifocal or multi-focal corrective lens<\/a> may be prescribed if the amount of inward turn is greater for closer objects than farther ones. When the eyes are aligned by corrective lenses they may spontaneously begin to work together. If this doesn\u2019t occur, then a vision therapy program can help to improve visual skills and clear binocular vision.<\/p>\n<h3><b>Vision therapy for treatment of accommodative esotropia<\/b><\/h3>\n<p><i>Consistent <\/i>eye turns cause the brain to actively ignore visual information coming from the affected eye (suppression), in order to prevent <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/neuro-optometry\/vision-and-brain-injuries\/double-vision-diplopia\/\">double vision<\/a>.\u00a0 During vision therapy, your doctor may recommend occlusion of the stronger eye (using an eye patch) to retrain the brain and eliminate suppression.<\/p>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/what-is-vision-therapy\/\">Vision therapy<\/a> is highly effective for the improvement of visual skills such as eye teaming, depth perception, and stereopsis\u2014 all necessary for clear binocular vision.<\/strong><\/p>\n<p>Esotropia that occurs <i>intermittently <\/i>does not usually require long term treatment. In this case, corrective eye wear may be recommended along with vision therapy, to improve ocular muscle coordination and eventually eliminate the bifocal.<\/p>\n<p>Patients with accommodative esotropia should never undergo eye muscle surgery to eliminate the need for eyeglasses, as it can cause significant focusing problems with age.<\/p>\n<h2><b>Partially accommodative esotropia<\/b><\/h2>\n<p>In some instances, part of the inward turn is due to basic esotropia, while an additional amount is due to the effects of accommodation.<\/p>\n<p>For partially accommodative esotropia, most eye doctors typically recommend eyeglasses (to reduce some of the eye turn) in addition to vision therapy (to retrain the visual centers of the brain).<\/p>\n<p>Surgery can be another treatment option to address the non-accommodative portion of the esotropia. However, surgery alone rarely results in clear binocular vision.\u00a0 For this reason, vision therapy will most likely be recommended for full recovery of binocular vision.<\/p>\n<p><strong>Eyeglasses and vision therapy are the most effective treatments for esotropia.<\/strong><\/p>\n<p><strong>LEARN MORE:\u00a0<\/strong><a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/\">Guide to Eye Turns<\/a><\/p>\n<p><a href=\"https:\/\/www.optometrists.org\/practice-search\/\"><strong>Schedule a comprehensive eye exam<\/strong><\/a> with your optometrist to obtain a proper diagnosis of esotropia and begin an appropriate treatment plan.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Esotropia is a form of strabismus (crossed-eyes) that is caused by an inward turn of the eye, toward the nose. This condition can be constant or intermittent and cause an individual to appear &#8216;cross-eyed&#8217;.<\/p>\n","protected":false},"author":4,"featured_media":1261,"parent":991,"menu_order":114,"comment_status":"closed","ping_status":"closed","template":"template-article.php","meta":{"footnotes":""},"categories":[],"tags":[85,285,198,283,88,230,217,113,115,390,83],"class_list":["post-280","page","type-page","status-publish","has-post-thumbnail","hentry","tag-children","tag-esophoria","tag-esotropia","tag-exotropia","tag-eye-turns","tag-eyeglasses","tag-hyperopia","tag-lazy-eye","tag-strabismus","tag-strabismus-surgery","tag-vision-therapy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What Is Esotropia? - Optometrists.org<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/esotropia-inward-eye-turn\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What Is Esotropia? - Optometrists.org\" \/>\n<meta property=\"og:description\" content=\"Esotropia is a form of strabismus (crossed-eyes) that is caused by an inward turn of the eye, toward the nose. 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