Esotropia: Types, Symptoms, Causes, Diagnosis, Risk Factors and Treatment

It is a visual abnormality known to deviate the eyeball to the nasal region.

It usually begins after six months of life, and in some cases, it is detected because the brain suppresses the image detected by the affected eye or eyeball.

The deviation is convergent and can affect any patient. However, it must be corrected in childhood before it deteriorates the eyeball much more, thus reducing its functions to the point that the eye cannot distinguish or focus on the image you are viewing.

Types of esotropia

This condition is not usually the same in all cases; at the time of carrying out the pertinent examinations and the diagnosis, the treating physician must identify which of the three types belongs to the one that the patient has, which are presented below:

Congenital esotropia

This condition develops when the individual is approximately six months old and is transmitted by the parents of the affected person because its acquisition is found in the genes.

For an individual to suffer from congenital esotropia, their closest relatives, in this case, the parents or even their grandparents, whether on the maternal or paternal side, suffered from some similar or even the same anomaly.

When it is discovered in time, specialist doctors suggest a surgical intervention to correct the error early, recommending 18 months of life as the most appropriate age.


After surgery, you must monitor thoroughly to prevent the condition or abnormality from mutating or becoming farsighted.

The most common characteristics of congenital esotropia are involuntary movements of the eyeball, called nystagmus or even torticollis.

Concomitant Acquired Esotropia

It is the most common or the most frequent case in patients suffering from esotropia. It usually appears between 2 and 3 years of age and is also inherited by one of the parents because it is found in their genetics.

One of the factors that differentiate it from congenital esotropia is that it may or may not appear in the development of the child or individual.

Concomitant esotropia acquired from the moment of its appearance, the deviation can increase intermittently, slowly, or accelerated. Therefore, early diagnosis can reduce the effects of this condition.

Surgical intervention and its rigorous control are recommended for a deeper and more assertive correction to mitigate damage or future problems.

Accommodative Endotropy:

In most of the known cases, it appears after three years of age and is not necessarily inherited by the parents of the affected person.

It usually develops progressively over time, and the level or degree of hyperopia is not necessarily linked or linked to the convergent deviation of the eyeball.

Its damage is usually maintained or reduced with corrective lenses or particular parameters. However, if neither method works and the ocular damage increases, the individual must undergo a surgical intervention to correct the condition.


The symptoms of esotropia vary according to its causes and characteristics, but the most prevalent feature is the deviation of the eyeball towards the nasal region.


It usually arises from a genetic abnormality inherited from the parents. It can also be caused by paralysis of the external ocular motor nerve or by poorly performed eye surgery for strabismus.

Diagnosis of esotropia

People who suffer from some esotropia should perform several tests when the deviation is not so noticeable to diagnose the condition because the symptoms could be confused with other types of diseases, such as:

  • Lazy eye.
  • Squint.

Risk factor’s

Among the risk factors of people who have this condition, either by genetics or by acquiring them over time, are:

  • Squint.
  • Amblyopia.
  • Misaligned eyes.
  • Cataracts in childhood glaucoma.
  • Pediatric glaucoma.

Treatment for esotropia

The best thing to do when detecting the condition is that the baby or child undergoes a surgical intervention to correct the anomaly. Otherwise, they could suffer other diseases of the eyeball such as glaucoma or even blindness in the future.

However, depending on the type of esotropia, corrective lenses or other corrective methods may be used while the individual is old enough to undergo surgery, such as:

  • Bifocal lenses: are responsible for correcting the visual impairment suffered by the child or patient.
  • Miotics: it is a substance or liquid that is placed in the eye that produces intense miosis that causes a contracture of the ciliary muscle.