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Accommodative Esotropia

More about Squints

What is an Accommodative Esotropia?

Accommodative esotropia in children is one type of esotropia which is a type of squint where the eye turns inwards or towards the nose.   This is one of the few squints which are corrected by the child wearing glasses or high plus powered lenses and not by surgery.

When does Accomodative Esotropia occur in Children?

Accommodative esotropia occurs after the first few years of life usually at 4-5 years of age though sometimes we do see this squint in younger children.  Parents often complain of the child’s eyes squinting inwards but only sometimes, not all the time.  They may also add that the squinting is more when the child is looking at near objects.

Why does Accomodative Esotropia occur?

Children with accommodative esotropia are born with a high hyperopic error or a high plus power.  When someone has a high plus power they have to accommodate to see clearly.  Let's say accommodate means to focus.  So if they focus in spite of having a high plus power and not wearing glasses, these children can see clearly.  However, there is a direct link between accommodation and convergence or how much both the eyes move inwards.  Thus every time we focus the eyes turn a little inwards.  The more we focus the more they turn inward.

Since these children have a high plus power they have to accommodate a lot and thus their eyes turn inwards.  One will notice the squint only when the child accommodates or focuses or attempt to see things clearly.  If the child is daydreaming and not focussing on things then one may not notice the squint at all.

What is the treatment of Accomodative Esotropia?

Thus the treatment of accommodative esotropia aims at getting rid of the child's focusing which means giving the child glasses of a high plus number.  This number is found out by putting some eye drops or eye ointments in the eyes for 3 days and then seeing the child again at the clinic.

Once the glasses are given the accommodative esotropia could take a few months to stop being visible and it does not happen right away.  The child may also not like the glasses initially and may complain of blurry vision with the glasses.  Parents should stand their ground with their children and in a week or so the blurriness would decrease.
This is unlike the treatment for another type of esotropia or squints.  You can read about Infantile or Congenital EsotropiaDuane's Syndrome, and treatment of Adult squints.

You can read more about accommodative esotropia.

Frequently Asked Questions ?

How often does my child have to wear glasses?
The glasses that we prescribe have to be worn all the time and forever. Whenever the glasses are taken off the child will have to focus to see clearly and the squint will reappear.
Is there anything I can do to get rid of my child's glasses ?
As mentioned earlier the glasses have to be worn for ever. As the child gets older the child could wear contact lenses if these are available for this number. After the age of 18 the child could also consider getting lasik done to get rid of his number again depending on his number.
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