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Infantile Esotropia - What Is It And How To Treat It?


Infantile esotropia is a condition most commonly referred to as “cross eyes.” It can be diagnosed if there is an inward turning of one or both eyes during the time between birth and the first six months of an infant’s life. It has also been called congenital esotropia.

This condition does not have any definite linkage to other neurological problems. Infantile esotropia is most often characterized by a large and constant angle of deviation greater than 30 degrees.

1. Causes

The cause of this condition remains unknown till date. Some researchers have hypothesized that it could be a result of sensory or motor dysfunction in the child. It can be considered a dysfunction in the development of normal binocular sensitivity (normal vision with two eyes). However, there are certain risk factors, which may contribute to the development of this condition, such as premature labour, intraventricular hemorrhage, genetic predisposition, delay in neurological development and seizures.

2. Related Conditions

Infantile esotropia increases the chances of developing amblyopia - impaired or dim vision with no obvious defects in the eye. It may also lead to a phenomena called cross fixation - it is when one eye is used to view the visual field of the opposite side. For example, the left eye is used to look at the right visual field. This may occur due to the inability of the child to accurately focus on a target.

Another condition that occurs in about 75% of infants that suffer from infantile esotropia is Dissociated Vertical Deviation (DVD). This is the case when the non-fixing eye moves upward when not in use or when inattentive to any target.

Latent nystagmus is another condition that may occur, and is seen in about 50% of children with infantile esotropia. In this condition, horizontal, involuntary jerks of the eye can be observed. These jerks come about due to the obstruction of either eye.

Infants may also suffer from a condition called inferior oblique overaction or IOOA. This is a condition in which there is over-elevation of the eye in supra-adduction and is seen in about 70% of infants with infantile esotropia.

Most children with the condition tend to exhibit hampered abilities of depth perception. This can be found out when they reach an age at which depth perception is testable. 

3. Treatment

If your child has accommodative or small angle esotropia, spectacles are often enough to correct this condition. In more severe cases, however, corrective surgery may be required. In some cases, amblyopia is treated before the corrective surgery. Some surgeons may also prefer to perform the corrective surgery before administering treatment for amblyopia.

Getting the surgery done earlier on is most beneficial, as it may ensure the most efficient performance of both eyes. However, it is also more difficult to perform the surgery very early as younger children have smaller faces.

After surgery, if your child requires it, make sure to follow up with the doctor to ensure that the eye alignment is as it should be and that they are healing safely and properly. Do ensure that you go to a good and trusted doctor, as there may be complications that could arise, if anything goes wrong in surgery. Treating it early is the key to solving the problem with the least amount of damage possible.

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