Esotropia

What is esotropia and what are the common symptoms and treatment procedures?

People with esotropia tend to have one of their eyes facing inwards, rather than facing forward in a straight direction. In rare instances, both eyes are facing inwards. Often people confuse esotropia with a lazy eye, but actually these conditions are quite different. Esotropia is a type of strabismus (squint), where the eyes are misaligned, which causes the eyes to look inwards and can prevent the eye perceiving images in depth.¹

Ophthalmologists ask parents of children with esotropia to get their eyes treated as early as possible. This is because delaying treatment only makes their eyes more liable to develop more serious eye conditions at a later stage.

Here are some of the complications infants and children may experience if their esotropia is neglected:²,³

Inability to process 3-D vision
Loss of thorough image perception
Developing amblyopia – a condition which involves the decrease of clear vision in the child’s crossed eye

Below are also some of the complications older children and adults may face if their esotropia is undiagnosed and/or remains untreated:⁴

Seeing double (diplopia)
Problems with seeing images in depth and with clarity
A decrease in binocular vision

Esotropia symptoms

Here are some of the symptoms patients may experience with esotropia:⁶

Eyes turning inwards, presenting a blurry and distorted view
Both eyes crossing inwards
Developing amblyopia or a lazy eye – a condition that involves one eye receiving weaker brain signals, subsequently causing it to become 'lazy' in response.
Inability to focus sight on the same point and at the same time. People with esotropia usually only view objects completely using one eye.

How is esotropia caused?

So how does esotropia occur?

Esotropia is a form of strabismus (squint).
Esotropia can occur genetically and is common if the child's family has a medical history of strabismus.⁷

How is esotropia treated?

Esotropia treatment depends on how severe it is and you may need repeated treatments to correct the eye misalignment. Another factor to consider before going ahead with treatment is how long you have had esotropia.

For a baby who has had esotropia for just a few months, the chance of treating it is much higher. However, if treatment is being done on an adult patient who has had esotropia for decades, it may take longer to correct the condition, and may require more than one surgical procedure.

Your optometrist may be able to treat the following complications:⁸,⁹

Misaligned eyes
Double vision
Visual barriers, such as incorrect lens prescription
Amblyopia (lazy eye)

Your optometrist may also treat your esotropia with the following options:

Prescription glasses and/or contact lenses: This is the first choice for optometrists, as glasses and contact lenses are painless and more affordable than surgery.
Vision therapy:. The optometrist focuses on building strength in the muscles surrounding the eye. This can improve the vision of the affected eye. This is done by placing a patch over the dominant eye, so the affected eye can exercise its ability to focus on an object independently.
Botox injections: Not often recommended, but sometimes Botox injections are advised.
Surgery: This is not performed by the optometrist, but by an ophthalmologist. This is considered a last resort and is not suitable for every type of esotropia. Eye surgery can correct the eye’s misalignment and may improve visual acuity. After the age of 14, this surgery is purely for cosmetic reasons.

Medically reviewed by Dan McGhee on September 29, 2022

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