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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.
Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms. Pencil push-ups therapy is performed at home. The patient brings a pencil slowly to within 2–3 cm (0.79–1.18 in) of the eye just above the nose about fifteen minutes per day five times per week.
Prism correction. Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Eye care professionals use prism correction as a component of some eyeglass prescriptions. A lens which includes some amount of prism correction will displace the viewed image horizontally, vertically, or a combination of both directions.
If the residual esotropia is small, or if the patient is unfit or unwilling to have surgery, prisms can be incorporated into their glasses to provide more permanent symptom relief. When the deviation is too large for prismatic correction to be effective, permanent occlusion may be the only option for those unfit or unwilling to have surgery.
Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".
Surgery or special glasses (prisms) may be advised if there is no recovery in 6 to 12 months. If diplopia turns out to be intractable, it can be managed as last resort by obscuring part of the patient's field of view.
Cyclotropia cannot be corrected with prism spectacles in the way other eye position disorders are corrected. (Nonetheless two Dove prisms can be employed to rotate the visual field in experimental settings.) For cyclodeviations above 5 degrees, surgery has normally been recommended.
The most common strabismus finding is large angle exotropia which can be treated by maximal bilateral eye surgery, but due to the progressive nature of the disease, strabismus may recur. Those that have diplopia as a result of asymmetric ophthalmoplegia may be corrected with prisms or with surgery to create a better alignment of the eyes.
Strabismus surgery attempts to align the eyes by shortening, lengthening, or changing the position of one or more of the extraocular eye muscles. The procedure can typically be performed in about an hour, and requires about six to eight weeks for recovery.
In a study performed on 53 children who had amblyopia due to anisometropia, surgical correction of the anisometropia followed by strabismus surgery if required led to improved visual acuity and even to stereopsis in many of the children [9] ( see: Refractive surgery ).