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Ophthalmology. Esotropia is a form of strabismus in which one or both eyes turn inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. [1] It is the opposite of exotropia and usually involves more severe axis deviation than esophoria.
Esophoria is an eye condition involving inward deviation of the eye, usually due to extra-ocular muscle imbalance. It is a type of heterophoria. Cause. Causes include: Refractive errors; Divergence insufficiency; Convergence excess; this can be due to nerve, muscle, congenital or mechanical anomalies.
If the eye was exotropic, covering the fixating eye will cause an inwards movement; and if esotropic, covering the fixating eye will cause an outwards movement. The alternating cover test, or cross cover test is used to detect total deviation (tropia + phoria).
Esotropia. In an Esotropic (ET) deviation, the patient will experience uncrossed diplopia. When questioned about the position of the lights, they will report that: They see 5 lights, 2 red and 3 green; The lights are horizontally displaced, seen side by side; The 2 red lights from the right eye are seen on the right side
If the patient saw a red line to the right and white light to the left, they are said to have esotropia or esophoria (uncrossed diplopia) in which base out (BO) prisms of increasing strength are used until the lines are superimposed.
Risk factors include premature birth, cerebral palsy, and a family history of the condition. [3] Types include esotropia, where the eyes are crossed ("cross eyed"); exotropia, where the eyes diverge ("lazy eyed" or "wall eyed"); and hypertropia or hypotropia where they are vertically misaligned. [3]
Anisometropic persons who have strabismus are mostly far-sighted, and almost all of these have (or have had) esotropia. However, there are indications that anisometropia influences the long-term outcome of a surgical correction of an inward squint, and vice versa.
For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).
Fusional vergence dysfunction (reduced positive and negative fusional vergence, with normal or near-normal phoria) Heterophoria. Vergence control, and over-convergence associated with the extra accommodation required to overcome a hyperopic refractive error, play a role in the onset of accommodative esotropia.
Relaxation of accommodation can result in an increase in exophoria and a decrease in esophoria, leading to an inaccurate result. The examiner should check the function of the Maddox Wing Instrument before use; the septa can be easily bent, leading to the septa not covering the intended view.
