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Esotropia or crossed eyes

Approximately 13 million Americans suffer from strabismus, which affects approximately 4% of the population.

Esotropia or crossed eyes in Hixson

 

Amplify Eyecare Chattanooga

Esotropia, commonly called crossed eyes, is a condition that affects 1-2 percent of the population whereby a person uses only one eye to look at objects while the other eye turns inward. Esotropia is a form of strabismus which is the inability of both eyes to align together to look at an object.

Symptoms of esotropia

Following are the common symptoms of esotropia:

  • You may have blurred or distorted vision due to inward deviation of eyes
  • You may look cross eyed
  • You may develop amblyopia (a condition in which vision is suppressed in one eye)
  • You may find it difficult to focus at an object that is nearby or at distance
  • You may find yourself reading or viewing an object with just one eye

Why do we need both of our eyes for great vision?

Esotropia or crossed eyes is not just a cosmetic issue, it deeply impacts many aspects of a person's life by disturbing their binocular vision. Binocular vision is the term that refers to the use of both of our eyes together to see the world. For a person with esotropia things that require both eyes working as a team become much more difficult. For example when we read, use a phone, drive a car, ride a bicycle, walk down the street, or play sports we use binocular vision to perform these tasks. When a functional optometrist works with an esotropic patient, the goal is to restore binocular vision.

Why do we need both of our eyes for great vision?

Dr. Heather McBryar

Dr. McBryar runs a specialty optometry practice, Amplify EyeCare Chattanooga, located in Hixson, Tennessee. Dr. McBryar specializes in the fields of developmental optometry, working with children and special needs to realize their full potential. 

She has many achievements in her field:

  • Diplomate of the American Board of Optometry (ABO)
  • Fellow of the College of Optometrists in Vision Development (COVD)
  • Candidate for Fellowship in the Neuro-Optometric Rehabilitation Association (NORA)

What causes esotropia?

Our eye movements are controlled by extraocular muscles. These muscles keep our eyes aligned when we are looking at an object. If there is a problem with these muscles it may result in different types of eye misalignments such as esotropia.
A patient's family history may also contribute to this condition. Approximately 30% of children with strabismus have a family member with the same condition.
Esotropia can also be caused by:

  • Refractive errors such as farsightedness
  • Poor vision in one eye
  • Head injuries
  • Neurological issues such as down syndrome, cerebral palsy, hydrocephalus, brain tumors
  • Certain systemic diseases, like hyperthyroidism or diabetes

How is esotropia treated?

Esotropia must be detected and treated early in order to be effectively treated. During the early stages of development, the child's brain is adaptive and has a high chance of responding well to treatment. The good news is that there are effective treatments for esotropia for patients of all ages. Treatment of esotropia is determined on a case by case basis, where the functional optometrist will assess the underlying causes of the esotropia and the ideal treatment for that patient.

Treatment for esotropia involves treating the underlying cause, which may include:

  • Double vision
  • Weak extraocular muscles (responsible for eye movements)
  • Farsightedness (hyperopia)
  • Amblyopia (lazy eye)
  • Binocular vision dysfunction

Vision therapy: Vision therapy has been shown to be an effective, permanent, and non-invasive way to treat esotropia. The goal of vision therapy is to train the brain to use both eyes in tandem to achieve great vision. Vision therapy for esotropia is often done in combination with special prism lenses. The therapy is done in office under the guidance of the functional optometrist and a vision therapist. The in office sessions follow a series of repeated exercises,tailored to the patient's visual deficits and progress. You can schedule an eye exam for vision therapy with our developmental optometrist by calling (423) 710 3965.

Patching is another treatment option especially in patients with acquired esotropia caused by amblyopia. This option forces the brain to utilize the eye that has been ignored. For best results patching should be done in combination with vision therapy in order to promote binocular vision once the amblyopic eye is being used.

Surgery may be performed on your extraocular muscles to fix the misalignment of your eyes. It is performed by an ophthalmologist which may be recommended by our optometrist if necessary. Ideally surgery is done in combination with vision therapy, which allows for the combination of fixing the muscle alignment while reintegrating binocular vision for the patient through therapy.

With eyeglasses, accommodative esotropia can be treated by reducing focusing effort and convergence of the eyes.

Eyeglasses with prisms may also be prescribed to correct the misalignment of the eyes, effectively correcting esotropia.

Why do we need both of our eyes for great vision?

Types of esotropia

Intermittent esotropia

This type of esotropia does not cause eye deviation constantly. If a person has this type of esotropia, their eyes may deviate inward after doing near work for a long time.

Infantile esotropia

Infantile esotropia usually manifests within the first six to twelve months of life. Most children develop controlled eye movements before the age of 6 months, but they don't have them during the first few months of life. Esotropia in infants is evident by a large angle deviation. It is also associated with latent nystagmus.

Accommodative esotropia

Typically, this type of esotropia develops between 1 and 4 years of age. Initially, it is intermittent, but over time it becomes more frequent. It usually occurs in children who are more farsighted than usual. Their eyes have to work harder to see clearly when viewing an object that is up close. Due to this excess effort, the eyes become over-converged or crossed.

Acquired esotropia

Unlike esotropia that develops earlier in life, acquired esotropia develops later in life. It could be due to untreated hyperopia (inability to close up objects clearly), double vision, lazy eye (amblyopia) or diabetes.

Sensory esotropia

This type of esotropia occurs in children less than 4 years old. A child with impaired vision in one eye is most likely to suffer from this condition. To get clear vision, our brain must fuse images from both eyes. When one eye does not have good vision, it drifts inwards causing esotropia.

Dr. McBryar cartoon

Summary

Esotropia is a form of strabismus in which one eye drifts inwards towards the nose while looking at an object that is closeby or at distance. There are many types of esotropia, which can be caused by double vision, amblyopia, hyperopia, weak extraocular muscles, or neurological conditions. Depending on the underlying cause, esotropia may be treated with eyeglasses, patching, vision therapy, surgery, and prisms. A vision therapy program can provide lasting effects and reduce the symptoms of esotropia and is often combined with other treatment options such as surgery or patching for better results. No matter how big or small your esotropia angle is, we can help you manage it and deal with it. You can schedule an eye exam for vision therapy (also called a functional or developmental eye exam) with our functional optometrist at Amplify EyeCare Chattanooga by calling (423) 710 3965. Patients with eye alignment issues such as esotropia visit our clinic from all over Tennessee, and we are proud to be a leading provider of vision therapy services for patients from Hixson, Chattanooga, Cleveland, and Middle Valley.

Testimonials


Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.


Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.


Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!


Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

Thank you!


Olivia C.

Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

Seems much more confident

Thank You!!!


Kelly O.

When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!


Alice M.
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