Congenital Esotropia, a form of inward deviation, typically occurs within the first 6 months after birth. The angle of deviation in these children is usually wide and often exceeds 30 prism diopters. In some children, a condition known as cross-fixation may also be present, where the right eye can look to the left, and the left eye can look to the right, causing significant concern for their families. Additionally, these children may sometimes experience upward deviation, eye trembling, and other related conditions alongside inward deviation. While occasional deviations may be observed within the first 3 months, the deviation generally becomes constant within the first 6 months.
What are the causes of infantile esotropia?
Although the exact cause is unknown, some theories have been proposed.
- Genetic factors (Hereditary)
- Damage to the visual system
- Dysfunction of the motor muscles around the eye
How is the diagnosis of infantile esotropia made?
Observant parents often notice the eye misalignment in their child early on. It is important to distinguish this type of strabismus from other forms. Questions should be asked about the child’s birth weight, any problems during birth, and overall health issues. The eye movements, the degree of misalignment, whether it occurs in one eye or both eyes, and whether there is any eye trembling should be examined. Eye drops may be used to ensure there are no other eye conditions. Examining the degree of eye misalignment after the drops are administered is also crucial. In some cases, special tests may be needed.
Is infantile esotropia a dangerous condition?
Infantile Esotropia is indeed one of the more dangerous forms of strabismus. If not treated early, it can lead to various problems such as vision loss, amblyopia (lazy eye), three-dimensional vision impairment, and binocular vision loss.
How is this condition treated?
Most of these patients require surgery. However, the treatment can be divided into two stages.
- Glasses and amblyopia treatment
- Surgery
Some surgeons recommend treating amblyopia first, while others suggest surgery first and then amblyopia treatment. Regardless, regular treatment and follow-up are essential for these children until a certain age.
How is the surgery performed?
The primary goal of surgery is to correct the misalignment in a way that provides binocular vision. Sometimes a single surgery may suffice, while other times multiple surgeries may be necessary. The surgery is performed under general anesthesia and typically takes between 30 minutes to 1 hour.
Is postoperative follow-up important?
One of the most critical aspects is postoperative follow-up. Even if the strabismus is corrected, these children must be monitored until a certain age to address issues like amblyopia, decreased vision, and sensory visual development.