Definition:

Congenital esotropia is a type of strabismus, or misalignment of the eyes, in which one or both eyes turn inward towards the nose from birth or early infancy. It is a condition that is present from birth, hence the term “congenital.” This inward deviation of the eyes affects the ability to align and focus both eyes on a single point, leading to visual impairment and potential long-term complications if left untreated.

Characteristics:

1. Inward eye deviation: The primary characteristic of congenital esotropia is the inward turning of one or both eyes, typically noticed soon after birth or within the first few months of life.

2. Constant misalignment: The eye misalignment persists throughout the day, regardless of the focus or distance.

3. Unilateral or alternating: In some cases, only one eye is consistently misaligned, while in others, the misalignment may alternate between the two eyes.

Symptoms:

1. Crossed eyes: The most observable symptom is the apparent crossing of the eyes inward towards the nose.

2. Poor eye coordination: Difficulty in aligning both eyes to focus on a single object, causing impaired depth perception.

3. Squinting or closing one eye: Children with congenital esotropia may squint or close one eye to improve vision and reduce double vision.

4. Head tilting: Tilting the head to a side may be observed as an attempt to align the eyes better.

5. Amblyopia (lazy eye): If left untreated, congenital esotropia can lead to the development of amblyopia in the misaligned eye, resulting in reduced visual acuity.

Treatment:

1. Glasses or contact lenses: Corrective lenses may be prescribed to help improve vision and reduce eye strain. However, this treatment alone usually cannot correct the misalignment.

2. Eye patching: Occlusion therapy involving patching the stronger eye to encourage visual development in the misaligned eye may be recommended, particularly if amblyopia is present.

3. Eye exercises and vision therapy: Specific exercises and activities can be prescribed to improve eye coordination and strengthen the eye muscles.

4. Bilateral medial rectus muscle surgery: If nonsurgical treatments are unsuccessful, surgery may be performed to realign the eyes by adjusting the positioning of the eye muscles.

5. Continuous monitoring: Regular check-ups with an ophthalmologist are necessary to monitor progress, make adjustments to treatment plans, and address any potential complications.