What is Esotropia

esptropiaEsotropia, a form of Strabismus, is the inward deviation (turn) of an eye and occurs in 1.2% of children by 7 years of age and occurs equally in males and females.  In esotropia, one or both eyes turn in while in exotropia one or both eyes turn out.

Pseudoesotropia refers to the appearance of crossed eyes in a child whose eyes are actually perfectly aligned in relation to each other. This is common in infants and younger children who have a broad, flat bridge of the nose which allows the skin on the inner part of the eyelids to extend over and cover the inner part of the eye. The sclera (the white part of the eye) closest to the nose becomes partially covered, especially when the child looks toward either side, and a crossed eye appearance is simulated. As the face matures and the nasal bones grow, the skin is pulled forward and away from the eye, thereby eliminating the crossed eye appearance.

Congenital Esotropia
pseudoesotropia"Congenital" means from birth and, using this strict definition, most infants are born with eyes that are not aligned at birth. Only 23% of infants are born with straight eyes. In the majority of cases, one eye or the other actually turns outward during the neonatal period. Within the first three months the eyes gradually come into more consistent alignment as coordination of the two eyes together as a team develops.

True congenital esotropia is an inward turn of a large amount, and is present in very few children, but the infant will not grow out of this turn. True infantile esotropia usually appears between the ages of 2 and 4 months.

Infantile Esotropia
The baby with infantile esotropia usually cross fixates, which means that he or she uses either eye to look in the opposite direction. The right eye is used to look toward the left side, and the left eye is used to look toward the right side. By definition, they alternate which eye they are looking with. It is possible to help this type of strabismus with non-surgical methods, such as Eyerobics and/or glasses. Sometimes, clear tape applied to the inner third of each lens (occlusion) can reduce the tendency to turn inward. Prisms may aid alignment if the turn is not too large.

Some children who develop strabismus, in which coordination between the two eyes is poor, also have atypical gross motor development patterns. They typically skip the crawling stage with bilateral movements, and go right from creeping to standing. The interplay between gross motor, particularly balance systems (stems (cerebellar and vestibular) and binocular systems (motor control of the two eyes) is evident in the large number of young children with cerebral palsy who have strabismus.
If the inward turn of the eye is constant, and of a large amount, surgery may be indicated. Improved alignment may look better cosmetically, but it does not necessarily enable the brain to utilize information from both eyes together. Stereopsis, or two-eyed depth perception, is often poor following surgical treatment.

If amblyopia is present (poorer vision in the turned eye), therapy like Eyerobics which includes patching is often required so that the turned eye develops the capacity to see as well as the better eye. It is best to do this before surgery.

The chance of developing binocular vision with surgery alone diminishes with age. Getting the eyes to work together requires time and effort using a proper eye exercise program, but is worth it!

What are the symptoms

The person's eye or eyes appear to be turning in.
The deviation may occur while fixating (looking at) distance objects, near objects or both. See also above.

What causes Esotropia

The exact cause of the misalignment is not fully understood. Six eye muscles, controlling eye movements, are attached to the outside of each eye. In each eye, two muscles move the eye right and left. The other four muscles move it up or down and control tilting movements. To line up and focus both eyes on a single target, all eye muscles of each eye must be balanced and working together with the corresponding muscles of the opposite eye.

In children the misalignment can be due to a variety of causes including maldevelopment of the eye or even tumors.

The brain controls the eye muscles, which explains why children with disorders that affect the brain, such as cerebral palsy, Down's syndrome, and brain tumors often have strabismus.

Causes in adults can be quite varied and also require prompt medical attention. Double vision or strabismus can be the first sign of a serious medical condition including stroke, or brain injury.

How is Esotropia diagnosed

Your child's health care provider will first determine if the child truly has strabismus. If the child has strabismus, a workup will be done to determine the cause.

The physical examination will include a detailed examination of the eyes. The patient may be asked to look through a series of prisms to determine the differences between the eyes. The eye muscles will be tested to determine the strength of the extraocular muscles.

Tests include:

How can Esotropia be treated

A natural vision program that restores the proper function of the eye muscles has been very successful. Surgery is often not necessary. As a matter of fact, early surgery has the potential of disturbing the ability of the brain for fusion in the future and can cause a permanent reduction in vision (amblyopia).

Published success rates are higher for vision therapy than surgery. Many surgeons do not advocate vision therapy because they are surgeons and thus like to operate and/or they do not have the facilities to perform vision therapy, and/or have not read the medical literature on vision therapy and unaware of its proven success rates in the treatment of esotropia.

Remember, surgery may lessen the work load but it does not reinforce the eyes working together. Many surgical patients have their strabismus come back in the future. Many surgical patients have multiple surgeries without lasting positive results. Even if you have already had surgery it should be followed up with a Natural Vision Program like Eyerobics to ensure the return of the proper function of the eyes.

How can Eyerobics help

eye drawing

The Eyerobics program is a program of eye exercises based on the Bates Method. This is a well known method developed by Dr William Bates in the 20's.
The eye exercises are designed to address most eye disorders by improving the function of your eye muscles and at the same time relaxing them. Because the focus is on improving your eye muscles this program is very well suited to address esotropia. The problem with esotropia is the different tensions of the eye muscles. If all muscles would be as strong and tight than it would be impossible for your eye to involuntarily move to one direction.

The Eyerobics exercises are designed to address ALL muscles making them all as strong and relaxed. To discover all the advantages of the program, our money-back guarantee and the price, read on ...