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What is Accommodative Esotropia?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 12 September 2016
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Accommodative esotropia is an ophthalmological problem which is most commonly seen in children who are farsighted, but have not yet been diagnosed with vision problems. In children with accommodative esotropia, the eyes exhibit esotropia, in which one or both eyes turns inward toward the nose, as they attempt to focus on distant objects. Also known as “crossed eyes,” esotropia caused by vision problems is very correctable with a visit to an ophthalmologist, and the correction will make a huge difference in the quality of life for the patient.

People with hyperopia or farsightedness have small variations in their eyes which make it difficult to focus because the focal point of the person's vision is actually moved behind the retina. The eyes will do their best to compensate for the problem, and when someone is focusing intently on something or is very tired, one or both eyes may start to stray towards the nose during the attempt to focus. The umbrella term “strabismus” is used to describe situations in which the eyes do not align, and in the case of esotropia, strabismus manifests in the form of being cross eyed to some degree.

Often, accommodative esotropia can be treated with glasses or contacts to correct vision. Vision correction will limit the difficulty focusing, and reduce strain on the eyes. In some cases, bifocals may be prescribed to address vision problems with both near and distant objects. The improvement is generally almost immediate with glasses.

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In other cases, it may be necessary to conduct strabismus surgery to address the problem. Surgery is generally only recommended after it is clear that wearing corrective devices will not work. Before pursuing surgery for children with accommodative esotropia, parents should ask about the risks of the surgery, the healing time, and any special aftercare instructions which will need to be followed.

Eye problems in young children often go unrecognized unless the child presents with obvious symptoms like accommodative esotropia. The child may not realize that his or her vision is abnormal, especially before starting school. Once in school, eye problems are sometimes mistaken for learning disabilities or other problems, unless a child specifically identifies a vision issue such as being unable to see the blackboard. It is a good idea to take a child to an ophthalmologist periodically for examinations to confirm that the eyes are healthy and to identify the early signs of vision problems so that treatment can be provided in a timely fashion.

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