What is esotropia?
Esotropia is in-turning of one or both eyes.
Is esotropia ever ‘normal’?
Esotropia in infants less than 4-5 months old frequently resolves spontaneously, especially when the misalignment is intermittent and small in magnitude. However, one should see a squint specialist if there is persistent or constant eye crossing immediately.
What problems can esotropia cause?
The effect of esotropia on the visual system depends on the frequency/severity of eye crossing and age. Eye crossing affects the ability of the eyes to work together. Older children and adults with a new onset esotropia often experience diplopia (double vision) and or decreased binocular visual field. Children can lose stereopsis (3-D vision) and binocularity (simultaneous use of the eyes) in addition to loss of vision in the crossing eye (amblyopia).
Are there conditions that increase the risk of esotropia?
Prematurity, a positive family history, and various neurological and genetic disorders increase the risk of eye misalignment. Also some systemic disorders like hyperthyroidism, diabetes cause squint.
How does a Pediatric Ophthalmologist/ Squint specialist evaluate a child with suspected esotropia?
After taking a careful history, the child eye doctor assesses the visual acuity in a manner appropriate for age. It is important to determine whether the acuity is equal in each eye or if one eye is stronger than the other. Squint, if detected, is quantified using prisms. The childs’ eye is assessed for any refractive error.
What are the treatment options for esotropia?
Treatment modalities used to realign the eyes include spectacles (sometimes with prism or bifocal), squint surgery (eye muscle surgery) or botulinum toxin.