Crossed Eyes (Esotropia)

Eyes are described as crossed when one or both of the eyes turns in towards the nose rather than staying lined up straight.  There are many different reasons why eyes may cross.  In childhood, the most common reasons are either being born with crossed eyes (Infantile Esotropia) or late developing crossed eyes due to being very far-sighted (link to Accommodative Esotropia topic).  In rare situations, there may be a more serious condition causing the eye crossing.  If eye crossing is not addressed during early childhood, the child will not develop normal binocular vision (the ability to use both eyes together for depth perception) and they may even permanently turn one eye off, which is called Amblyopia

If you think your child’s eyes are crossing in, it is important to see a pediatric ophthalmologist to check for it, determine the cause, and see if there is any associated Amblyopia or a high need for glasses.  These conditions can often be easily treated in early childhood but are more challenging to treat when the child gets older.  Treatment may include close observation, glasses, and/or strabismus surgery.

Accommodative Esotropia

Accommodative Esotropia is a type of eye misalignment where the eyes cross because of a far-sighted need for glasses. Most commonly, children will begin to have an eye cross intermittently around age 2-4. It usually happens when they are focusing on an object, but will start to occur more frequently. Often, children will choose one ‘favorite’ eye and let the same eye cross in every time which can lead to amblyopia which can affect vision permanently.

Can crossed eyes or wandering eyes be fixed?

Most children with accommodative esotropia only need glasses and have little to no crossing when wearing their glasses. Often, this is the only treatment they need. Sometimes, their ‘favorite’ eye continues to still see better even with wearing the glasses for a few months, in which case we need to patch their ‘favorite’ eye to make their amblyopic eye see better. 

Occasionally, a child's eye crossing is only partly controlled with glasses and may require eye muscle surgery to correct it. After surgery, they will still cross their eyes with their glasses off. But your pediatric ophthalmologist will be very happy if the eyes are straight with the glasses on because they know that most children with accommodative esotropia will grow out of it during the early teenage years. They may need to continue wearing glasses into adulthood, but the eye crossing when they take their glasses off typically begins to resolve.

Seeing a Pediatric Ophthalmologist

If you think your child’s eyes are crossing in, it’s important to have it evaluated by a pediatric ophthalmologist so any eye misalignment (strabismus), amblyopia (“lazy eye”), or high need for glasses can be ruled out. These conditions can often be easily treated in early childhood but are more challenging to treat when the child gets older.

To schedule an appointment, call (509) 456-0107