Esotropia in Children – Turned in or Crossed eyes

Esotropia in children and adults is a type of strabismus or eye misalignment.

In esotropia, the eyes are “crossed”; that is, while one eye looks straight ahead, the other eye is turned in toward the nose. This inward turn of the eyes can begin in infancy or later in childhood.

Congenital (infantile) esotropia is a type of strabismus which first appears sometime within the first six months of life. This esotropia may be present at birth but often develops within the first few months. In the first months of life, it is common for the eyes to intermittently become misaligned.

If a misalignment of the eyes persists after the first few months, a consultation with a pediatric optometrist/ophthalmologist is required

One to two percent of children have congenital esotropia. Though the cause is unknown, it is thought that the underlying problem lies in the brain’s inability to coordinate the movement of the eyes. These children will often alternate their vision between the two eyes by sometimes crossing one eye, and at other times the other. Some children will constantly cross the same eye. This is often an indication that amblyopia, or decreased vision, is developing in one eye.

Treatment of congenital esotropia may require eye muscle surgery. Before surgery is performed, other factors must be considered.

If amblyopia has developed in one eye, this poor vision must be treated right away. This is accomplished by patching the better eye to force the brain to use the eye with poorer vision. Though this will not correct the eye crossing, it will equalize the vision which improves the prognosis for a successful outcome from surgery.

The presence of farsightedness must also be detected prior to an operation.

Accommodative esotropia is a common cause of esotropia in infants.
This means that when longsighted (Hypermetropia – plus) glasses are prescribed, the eye crossing diminishes.
Such children do not require surgery.