Infantile Esotropia - Causes, Symptoms, Diagnosis and Treatment

What Is Infantile Esotropia?

Infantile esotropia is a condition of the eye where either one or both eyes may seem to wander or not be straight. This condition may also be referred to as strabismus or wandering eye. This eye condition may be present since birth or develop within six months after birth. Hence at times, it may be referred to as congenital esotropia.

What Are the Various Positions of Eye Seen in Esotropia?

1. Esotropia- In this condition, one or both eyes may be turned inwards or positioned towards the nose. This type of strabismus has the highest occurrence.

2. Exotropia- In this condition, one or both eyes face outwards or may be positioned towards the ears.

3. Hypertropia- In this case, the affected eye is on a higher level when compared to the normal eye.

4. Hypotropia- In this case, the affected eye is lower than normal.

What Are the Different Types of Esotropia?

1. Infantile Esotropia-

• This condition may occur in almost one out of every 20 children. It may be present or develop within six months after birth. It might be present all the time or might occur occasionally. It develops because of weak musculature.

• This condition mostly resolves on its own. If it takes more than four months to resolve, it is advisable to consult the doctor. If the condition persists, then it may develop into lazy eye syndrome.

2. Accommodative Esotropia- It can be due to refractive errors such as farsightedness. It may develop a year after birth. Unlike infantile esotropia, it is a continuous progressive condition and may worsen over time if the refractive error is not corrected.

3. Pseudostrabismus- It is a condition with no actual muscle weakness or refractive error. It may occur due to anatomic variations. For example, a wide or nasal bridge with some extra folds. Due to these variations, it may look like the kid has strabismus or crossed eyes.

What Are the Causes of Infantile Esotropia?:

Infantile esotropia may be caused due to various reasons; some of the following are:

1. Weak Muscles- The duration of the onset of esotropia from zero to six months has a strong reason. This is the time period during which the eye musculature develops and becomes strong. At times the muscles of both eyes may not be in sync with each other. The exact reason behind this is unknown. Hence, a discrepancy may occur in the eye movements.

2. Family History of Esotropia- The infant presenting with esotropia may present with a strong familial history. Strong family history puts some infants at greater risk of developing esotropia than others. In such cases, it may be observed that a few other family members, such as a sibling or parent, may also present with strabismus.

3. Trauma to the Eye Musculature- Trauma to the eye muscles can lead to the eyes not being in union with each other, ultimately leading to esotropia.

4. Congenital Cataract- Some babies can be born with cataracts which are basically clouding around the cornea. At times during the surgical correction of cataracts, esotropia can be caused.

5. Refractive Errors- At times, babies may be born with refractive errors such as farsightedness. Uncorrected refractive errors can lead to muscular weakness, ultimately leading to esotropia.

6. Neurological Issues- Inherent issues of the nerves can lead to crossed eyes. Any congenital or acquired issues to the nerves supplying the eye muscles can lead to the loosening of the muscle structure. A loose muscle will give rise to crossed eyes.

7. Premature Babies- Premature babies may develop crossed eyes if the eye muscles are not fully developed.

8. Systemic Conditions- Esotropia can be seen in many systemic conditions such as Down syndrome and cerebral palsy.

What Is the Treatment of Infantile Esotropia?

Although in most cases, this condition may resolve on its own, sometimes it may require treatment. Treatment of this crossed eye is entirely dependent on its cause. Correction of the cause can lead to the resolution of the disease. The ultimate aim of the treatment is to strengthen the eye muscles. The various available treatment options are:

1. Eye Glasses- In case of esotropia caused due to refractive errors, eyeglasses can be prescribed to rectify the underlying condition, leading to resolution of the condition. Eyeglasses will help to balance the action of the muscles. It will help the weaker eye muscles to correct themselves.

2. Helping the Eye To Correct Itself- In conditions wherein only one of the eyes is affected, certain mechanisms can be applied to the normal eye to help the affected eye to correct itself. Such methods include:

• Using blurred glasses on the normal eye.

• Using eye drops that can make the normal eye blurry.

• Using eye patches on the normal eye.

3. Surgical Methods- In case of failure of the aforementioned treatments, surgical treatment may be required. The muscles that are responsible for this condition will be corrected using surgical intervention. The muscles can be tightened or loosened depending on the individual condition. This treatment largely has a good prognosis.

4. Usage of Botox Injections- Usage of botox injections will loosen the eye muscles, aiding in its correction.

Conclusion:

Esotropia, like many other conditions, is not preventable. Even when it does not resolve on its own, multiple treatment options are available which can rectify the crossed eye. But the treatment and rectification depend on the early and prompt diagnosis of the condition. It is better to report the condition as soon as noticed to one's pediatrician. Treatment may be suggested if the condition does not resolve on its own even after four months. If the treatment is delayed, it may lead to conditions like lazy eye syndrome. Due to this, other milestones of development may also be delayed. Hence it is advisable to receive treatment at the earliest in order to achieve a healthy vision for the kid.