From the Guidelines
Causes of Esotropia in Children
Esotropia in children is primarily caused by uncorrected vision problems, such as hyperopia (farsightedness), which can lead to accommodative esotropia, as well as strabismus (eye muscle imbalance) and certain medical conditions 1.
- Uncorrected hyperopia is a significant risk factor, as it can cause the eyes to turn inward in an attempt to focus, leading to esotropia 1.
- Strabismus, which can be congenital or acquired, is another common cause, where the eye muscles are imbalanced, causing the eyes to misalign 1.
- Additionally, certain medical conditions, such as cerebral palsy, Down syndrome, or stroke, can increase the risk of developing esotropia.
- Refractive errors, such as anisometropia (asymmetric refractive errors), can also contribute to the development of esotropia and amblyopia 1.
It is essential to consult a pediatric ophthalmologist for proper evaluation and treatment, which may include glasses, patching, or surgery, depending on the underlying cause. Early treatment is crucial to prevent long-term vision problems, such as amblyopia 1.
From the Research
Causes of Esotropia in Children
Esotropia, also known as crossed eyes or convergent strabismus, is a condition where one or both eyes turn inward. The causes of esotropia in children can be attributed to various factors, including:
- Refractive errors, such as hyperopia (farsightedness), myopia (nearsightedness), or astigmatism, which can cause the eyes to turn inward in an attempt to focus 2, 3
- Uncorrected refractive errors, which can lead to amblyopia (lazy eye) and increase the risk of developing esotropia 2, 3
- Vision problems, such as those not correctable with glasses or contact lenses, which have been linked to a higher prevalence of attention deficit/hyperactivity disorder (ADHD) and may contribute to the development of esotropia 4
Risk Factors for Esotropia
Certain factors can increase a child's risk of developing esotropia, including:
- Family history of strabismus or refractive errors
- Premature birth or low birth weight
- Certain medical conditions, such as cerebral palsy or Down syndrome
- Vision problems, such as amblyopia or uncorrected refractive errors
Importance of Early Detection and Treatment
Early detection and treatment of esotropia are crucial to prevent long-term vision problems and improve treatment outcomes. The American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Pediatrics recommend routine vision screening for all children, including red reflex testing, examination for signs of strabismus, and vision chart testing 5. Photoscreening may also be a useful adjunct to traditional vision screening, although its effectiveness in improving visual outcomes is limited 5.