Cross-eyed
| Esotropia | |
|---|---|
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| Classification and external resources | |
| Specialty | ophthalmology |
| ICD-10 | H50.0, H50.3 |
| ICD-9-CM | 378.0 |
| DiseasesDB | 29856 |
| MeSH | D004948 |
Esotropia is a form of strabismus in which one or both eyes turns inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is the opposite of Exotropia. Esotropia is sometimes erroneously called “lazy eye,” which describes the condition of amblyopia—a reduction in vision of one or both eyes that is not the result of any pathology of the eye and cannot be resolved by the use of corrective lenses. Amblyopia can, however, arise as a result of esotropia occurring in childhood: In order to relieve symptoms of diplopia or double vision, the child's brain will ignore or “suppress” the image from the esotropic eye, which when allowed to continue untreated will lead to the development of amblyopia. Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms and/or orthoptic exercises and/or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".
Someone with esotropia will squint with either the right or the left eye but never with both eyes simultaneously. In a left esotropia, the left eye 'squints,' and in a right esotropia the right eye 'squints.' In an alternating esotropia, the patient is able to alternate fixation between their right and left eye so that at one moment the right eye fixates and the left eye turns inward, and at the next the left eye fixates and the right turns inward. This alteration between the left and right eye is mostly spontaneous, but may be voluntary in some cases. Where a patient tends to consistently fixate with one eye and squint with the other, the eye that squints is likely to develop some amblyopia. Someone whose squint alternates is very unlikely to develop amblyopia because both eyes will receive equal visual stimulation. It is possible to encourage alternation through the use of occlusion or patching of the 'dominant' or 'fixating' eye to promote the use of the other. Esotropia is a highly prevalent congenital condition.
Esotropias can be concomitant, where the size of the deviation does not vary with direction of gaze—or incomitant, where the direction of gaze does affect the size, or indeed presence, of the esotropia. The majority of esotropias are concomitant and begin early in childhood, typically between the ages of 2 to 4 years. Incomitant esotropias occur both in childhood and adulthood as a result of neurological, mechanical or myogenic problems affecting the muscles controlling eye movements.
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