Definition:

  A misalignment of the eyes; a condition in which the eyes do not fixate as a pair, but one eye deviates inward, giving them a "crossed" look. While one eye looks straight ahead, the other eye is turned in toward the nose.  This inward deviation of the eyes can begin in infancy or later in childhood

Accommodative esotropia is the most common form of esotropia, occuring in farsighted children  two years old or older. When a child is young, they can focus their eyes to adjust for the farsightedness but the strain to focus stimulates the eyes to cross. In this case, prescription glasses reduce the focusing effort and can straighten the eyes. Sometimes bifocals are necessary for close work.   Eye exercises occasionally help older children.

Pseudoesotropia is the appearance of crossed eyes in which the eyes are actually perfectly aligned in relation to each other.  This form of esotropia is common in infants and younger children where the skin on the inner part of the eyelids extends over and covers the inner part of the eye.  The white of the eye closest to the nose becomes partially covered, especially when the child looks toward either side, giving the appearance of  crossed eyes.  However, as the child matures and the facial bones grow, the skin is pulled away from the eye with the growth of the nasal bridge, thereby eliminating the crossed eye appearance.

Acquired Esotropia can have multiple causes.  Most common are children who have been farsighted for awhile and have not had glasses, or children who wore glasses but later developed convergence even with the proper glasses. 

What are the symptoms? One eye "turning in" toward the other; both eyes turning inward.

What is the treatment?  Eye exercises can aid in improving eye muscle strength and can resolve some cases of esotropia. . In cases of infants and children, glasses may be prescribed. Eye drops, ointment or special lenses called prisms can also be used to straighten the eyes. Finally, Eye muscle surgery can correct such deviations and restoration of binocular vision is often possible.