Esotropia is a type of strabismus (eye misalignment) where one or both eyes turn inward towards the nose.
Understanding Esotropia
Esotropia isn't a single "syndrome" but rather a condition with various causes and classifications. The key characteristic is the inward deviation of one or both eyes. This misalignment can be constant or intermittent, and it can affect one eye or alternate between both.
Types of Esotropia
Several classifications help define the specific type of esotropia:
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Congenital (Infantile) Esotropia: Present at birth or develops within the first six months of life. It typically involves a large angle of deviation.
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Acquired Esotropia: Develops later in childhood or adulthood. Causes can vary.
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Accommodative Esotropia: Related to focusing efforts. Often associated with farsightedness (hyperopia). The eyes cross when the person focuses to see clearly. This type can sometimes be corrected with glasses.
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Intermittent Esotropia: The eye turns inward only sometimes.
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Consecutive Esotropia: Occurs after surgery to correct exotropia (outward turning of the eye), resulting in overcorrection.
Causes of Esotropia
The causes of esotropia are complex and can include:
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Muscle Imbalance: The muscles that control eye movement may be weak, overactive, or improperly innervated.
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Refractive Errors: Uncorrected farsightedness (hyperopia) is a common cause of accommodative esotropia.
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Neurological Problems: In some cases, esotropia can be caused by conditions affecting the brain or nerves that control eye movement.
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Genetics: A family history of strabismus increases the risk.
Symptoms of Esotropia
Besides the visible inward turning of the eye, other symptoms can include:
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Double Vision (Diplopia): Especially in cases of acquired esotropia.
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Eye Strain: Difficulty focusing and eye fatigue.
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Head Tilting or Turning: To compensate for the misalignment.
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Reduced Depth Perception: Difficulty judging distances.
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Amblyopia ("Lazy Eye"): In children, the brain may suppress the image from the misaligned eye, leading to reduced vision in that eye.
Treatment of Esotropia
Treatment aims to straighten the eyes, restore binocular vision (the ability to use both eyes together), and prevent or treat amblyopia. Options may include:
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Eyeglasses: To correct refractive errors.
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Vision Therapy: To improve eye coordination and focusing skills.
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Prism Lenses: To help align the images seen by each eye.
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Botulinum Toxin (Botox) Injections: To weaken overactive eye muscles.
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Eye Muscle Surgery: To reposition the eye muscles and improve alignment.
