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Congenital Esotropia

What is Congenital Esotropia ?

Esotropia is an inward turning of one or both eyes. Congenital esotropia begins at birth or during the first year of life. Congenital esotropia is also called infantile esotropia.

Why does infantile esotropia occur?

The cause of infantile esotropia is unknown. We know there is an inability to use the two eyes together. Hypotheses include both sensory and/or motor dysfunction.

Is infantile esotropia associated with vision loss?

There is increased risk for the development of amblyopia (lazy eye). It occurs because the brain ignores input from squinting eye.

What is cross fixation?

Cross fixation is the use of the right eye to view the left visual field and the use of the left eye to view the right visual field. This behavior is very common in children with infantile esotropia. Cross fixation often causes the appearance of not looking directly at a target and parents often wonder if vision is reduced.

Do infants with infantile esotropia need glasses?

Children with infantile esotropia are usually not more nearsighted or farsighted than those without crossing. However, if farsighted, spectacles may be prescribed.

Treatment

Usualy infantile esotropia is corrected by a squint surgery. In a squint surgery the position of some of the horizontal muscles of the eye is changed. The surgery is usually done around 1 year of age under General Anesthesia. The eyes remain red for about a couple of weeks. The advantage of performing early surgery is that the child may recover some or most of his / her binocular vision.

Frequently Asked Questions

When the eyes are squinting the brain ignores the image of the squinting eye.  This can lead to what is known as Amblyopia.

Because of squinting there is also loss of what is known as binocular vision.  Binocular vision is our ability to use both our eyes together and still see one object.  

The reason we operate at such a young age is to give a chance for binocular vision to develop.

There is a 20% chance that a second surgery would be needed.  This may be needed because as the child grows and adjustment occurs to the new muscle positions the position of the eye may change and we may need another surgery.

Patching is done to treat Amblyopia.  The squint surgery corrects the  postition of the eyes.  It however does not improve the vision of the weaker eye.  Thus patching may have to be continued even after the surgery.

The surgery per say would take about 30-35 minutes but because the surgery is done under general anesthesia the child will come out of the operation theater maybe an hour after going inside the Operation theater.

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