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Esotropia in the right eye. The light reflex is central in the left eye (the non-deviated eye), but over the iris in the right eye (the deviated eye).
Source publication
Whereas many animals have eyes located on either side of their head (such as horses, for example), the eyes of humans look forwards - in the same direction. When normal, the eyes move in a coordinated manner, so that the object being looked at is centred in each eye. Because the eyes are set a small distance apart, the image in each eye is slightly...
Citations
... It develops at an early age, as a result of suppression of the image from the deviated eye, or eye with uncorrected refractive error, or some kind of anatomical disorder (cataract, ptosis, hemangioma), the part of cortex responsible for interpreting the images coming from eye does not receive the stimulation necessary for normal development. As a result of untreated amblyopia, the affected eye develops lower visual acuity due to the abnormal development of the cortical visual pathway or abnormal binocular interactions [23][24][25][26]. ...
Treatment of strabismus should begin with non-surgical treatments such as visual acuity enhancement through optical correction, amblyopia treatment, prismatic correction, and orthoptic exercises. The goals of the treatment are to align the eyes in cases of accommodative strabismus, improve visual acuity, improve asthenopic problems, and preserve or restore function of binocular vision, when possible. The best way is to eliminate the causes that led to the development of strabismus.
... Esotropia is defined as misalignment of eyes, in which one eye deviates towards the nose. 1 The term esotropia is derived from ancient Greek, where "Eso" means "within" and "Tropia" means "a turn." In a study done in 2021 among school-going children, it was found that strabismus was present in 3.11% of the total children screened and further, it was observed that no significant differences existed related to gender among the study population. 2 As reported in 2019, in a meta-analysis by Hashemi et al., the estimated global prevalence of esotropia was reported as 0.77%. ...
Esotropia or convergent strabismus is a common type of squint in children. The esodeviation, the refractive error and the amblyopia should be examined and treated early to achieve good cosmetic correction and to improve Visual acuity.
A meticulous history of 25 children up to age of 12 years who presented with esodeviations was taken including the age of onset, duration and previous treatment. They were examined for amount and type of deviation by cover test, hirschberg corneal reflex test, Prism bar cover test and evaluated for refractive error under full cycloplegic correction, for Binocular Single Vision, diplopia, suppression and amblyopia by Worth four-dot test and RAF ruler. Ocular movements and fundus findings were recorded.
11 male and 14 female children with esodeviations with age of presentation varying from 9 months to 12 years were evaluated for type of esotropia. In our study the most common type seen in 12 cases (48%) is refractive accommodative esotropia with high hypermetropia. Non-refractive accommodative esotropia greater for near with high AC/A ratio in 5 patients (20%), Partially accommodative (mixed) esotropia in 2 cases, acquired non-accommodative esotropia seen in 2 patients. 1 case each is seen in Infantile esotropia, in Sensory esotropia, in child with Duane’s retraction syndrome (DRS) and in child having cerebral visual impairment (CVI).
Our study aimed to diagnose and manage the various types of esodeviations at an early age so as to maintain binocular alignment and a good Visual acuity to avoid progression to amblyopia.
... Strabismus is a condition where misalignment in the eyes is found, where in each case, one eye fixates on a specific point (the fixing eye) while the other eye can move to view the desired object (the deviated eye) [1]. Based on research was conducted at 2021, the overall incidence rate of strabismus is higher in adults compared to children, with a prevalence touching 4% [2]. ...
... Based on research was conducted at 2021, the overall incidence rate of strabismus is higher in adults compared to children, with a prevalence touching 4% [2]. In Helveston's study, it is mentioned that there are several types of strabismus [1]. Firstly, esotropia is a condition where there is a deviation in one eye that turns inward or appears cross-eyed. ...
... Secondly, exotropia is identified when one eye deviates outward or appears wall-eyed. Thirdly, there's deviation in one eye towards the vertical axis, hypertropia when the deviation is upwards, and hypotropia when the eye deviates downwards [1]. ...
Strabismus is defined as a misalignment of the anatomy of the human eye, presenting as ocular misalignment either inward towards the nose (esotropia) or outward (exotropia). Detecting strabismus is crucial as its misalignment not only affects one's appearance but also seriously disrupts the eye's function as a visual sense organ. Strabismus can affect the psychosocial condition of individuals, such as decreased self-confidence and self-esteem. This literature review assesses and compares the post-surgery between pre-surgery quality of life of strabismus patients.
... Ocular impairments include the assessment of refraction errors and fundus oculi abnormalities [20]. Oculomotor functions comprise fixation, smooth pursuits, and saccades [20,23], and oculomotor impairments include strabismus [28]. Geniculostriate functions entail visual acuity [29], visual fields [30], contrast sensitivity [31], stereopsis [32], and optokinetic nystagmus [33]. ...
Abstract
Objective
The structure–function relation between magnetic resonance imaging (MRI) and visual impairment (VI) in children with cerebral palsy (CP) has not been fully unravelled. The present systematic review aims to summarize the relation between brain lesions on MRI and VI in children and adolescents with CP.
Methods
PubMed, Embase, Web of Science Core Collection, and Cochrane Database were systematically searched according to the PRISMA checklist. A total of 45 articles met the inclusion criteria.
Results
White matter lesions were most frequently associated with VI. Only 25 studies described lesions within specific structures, mainly in the optic radiations. Only four studies reported on the thalamus. 8.4% of children with CP showed no brain abnormalities on MRI. Diffusion-weighted MRI studies showed that decreased structural connectivity in the optic radiations, superior longitudinal fasciculus, posterior limb of the internal capsule, and occipital lobe is associated with more severe VI.
Conclusions
All types of brain lesions lead to visual dysfunctions, arguing for a comprehensive visual assessment in all children with CP. Whereas white matter damage is a well-known contributor, the exact contribution of specific visual structures requires further investigation, to enable early prediction, detection, and intervention.
... S trabismus occurs when the eyes are not aligned to look at the same thing, one eye will be fixed where the person wants and the other eye is looking at something else, so each eye is sending a different image to the brain that normally shows the image of the normal eye perfectly and the image of the deviated eye will be blurred, but it may also be that the brain disregards the image of the deviated eye, and the person has only the vision of an object. [1] Purpose The purpose of this study is to demonstrate that the use of TCM tools, such as Chinese dietary counseling and acupuncture associated with apex ear bloodletting, could be effective in the treatment of strabismus after cerebral spactic paralysis sequalae of bacterial meningitis, once these tools treat the patients holistically, the energy imbalances and not just the symptoms. ...
Strabismus means misaligned eyes. Often strabismus eyes are referred to as “squinting eyes,” “crossed eyes,”and “wall eyes.” Usually, both eyes fixate equally while focusing on an object with the head held in the primary position.In strabismus or squint, one or both eyes deviate inward or outward and appear to be in non-alignment toward the directionof the focused object. For traditional Chinese medicine (TCM), the pathogenesis is attributed to congenital insufficiencyor Spleen-Stomach deficiency leading to reduced production of Qi and Blood that fail to transport essence to the eyes
... Certain cases of strabismus can be treated with refractive error correction alone while others will need vision therapy and/or surgical intervention depending on the severity of the oculomotor and neurosensory losses. 31 It has been previously reported that PL and/or dichoptic training led to some positive outcomes for strabismic patients concurrently being treated for amblyopia. 27,32 Myopia. ...
Background
Virtual reality is a relatively new intervention that has the potential to be used in the treatment of eye and vision problems. This article reviews the use of virtual reality-related interventions in amblyopia, strabismus, and myopia research.
Methods
Sources covered in the review included 48 peer-reviewed research published between January 2000 and January 2023 from five electronic databases (ACM Digital Library, IEEE Xplore, PubMed, ScienceDirect and Web of Science). To prevent any missing relevant articles, the keywords, and terms used in the search included “VR”, “virtual reality”, “amblyopia”, “strabismus,” and “myopia”. Quality assessment and data extraction were performed independently by two authors to form a narrative synthesis to summarize findings from the included research.
Results
Total number of 48 references were reviewed. There were 31 studies published on amblyopia, 18 on strabismus, and 6 on myopia, with 7 studies overlapping amblyopia and strabismus. In terms of technology, smartphone-based virtual reality headset viewers were utilized more often in amblyopia research, but commercial standalone virtual reality headsets were used more frequently in myopia and strabismus-related research. The software and virtual environment were mostly developed based on vision therapy and dichoptic training paradigms.
Conclusion
It has been suggested that virtual reality technology offers a potentially effective tool for amblyopia, strabismus, and myopia studies. Nonetheless, a variety of factors, especially the virtual environment and systems employed in the data presented, must be explored before determining whether virtual reality can be effectively applied in clinical settings. This review is significant as the technology in virtual reality software and application design features have been investigated and considered for future reference.
... A previous study on parents who reported signs and symptoms of eye problems among their offspring showed that more than 80% of parents were able to report physical signs of eye problems among their offspring compared to only 50% of parents able to report behavioural signs and symptoms (Chen et al., 2020). In this study, all pictures (100%) under the physical signs category provided a high percentage (more than 80%) of correct verbal responses as they represented a common ocular problem that can be observed by many people (Helveston, 2010). A majority (more than 80%) of the interpretation of pictures related to behavioural signs and visual-related activity provided incorrect verbal responses. ...
There is a recognised need for a questionnaire playing a crucial role in eye care. Substantial research has been undertaken on the role of a questionnaire assessing the vision-related quality of life. However, the need for pictures to be embedded as a part of the questionnaires has not been recognised. This study investigated the verbal and visual interpretation of pictures about signs and symptoms of eye problems. 60 subjects aged 18 to 40 years old were recruited using convenient sampling in this cross-sectional study. Sixteen pictures representing three domains (physical signs, behavioural signs and visual- related activity) were included. The verbal interpretation was recorded for each picture. The visual interpretation was recorded as fixation count and duration using a heat map for three pictures representing each domain. All pictures (100%) under the physical signs category provided a high percentage (more than 80%) of correct verbal responses. A significant difference in the verbal responses was found between gender and two different levels of education for behavioural signs and visual-related activity pictures (p<0.05). Significantly longer fixation duration was found among respondents who provided incorrect verbal responses compared to correct verbal responses (p<0.05). A simple picture with direct information like ocular misalignment was more interpretable than a picture with abstract information like ‘glare’ and ‘writing up and downhill’. Both verbal and visual interpretations of the picture are closely correlated. Therefore, selecting pictures of eye care questionnaires for the general population should consider a minimum cognitive load to improve interpretability.
... In another retrospective cohort study done in the USA, the prevalence of strabismus in 10 years was 60.1% for esotropia and 32.7% for exotropia [8]. 1 2 3 4 5 Strabismus derives from the Greek word strabismus which means "to look obliquely or to squint". It is a disease where the eyes do not align correctly while looking at a specific object [9]. This means that one eye may gaze straight ahead to an object while the other turns downward, upward, outward, or even inward [10]. ...
Background
Strabismus is a reversible condition that must be identified and treated during the critical period of childhood. Thus, this study aims to evaluate the degree of knowledge, attitude, and practice among parents of strabismic children in Riyadh, Saudi Arabia.
Method
To this end, a cross-sectional study was conducted from August 2021 to November 2021 with a sample size of 424 parents of children with strabismus seeking ophthalmologic consultants in private and governmental ophthalmology clinics in Riyadh, Saudi Arabia. A self-administered questionnaire was used to collect the data. The questionnaire contains knowledge-related questions about strabismus, beliefs-related questions, questions addressing the barriers parents face regarding strabismus in a child, and sources of information about cross-eye and its management. Data were analysed using the SPSS database version 21 (IBM Corp., Armonk, NY, USA). P-values <0.5 was used for clinical significance.
Result
We found that most parents know there is a relationship between strabismus and refractive errors (69%) and cross eye can be corrected (55%). Moreover, strabismus causes psychosocial difficulties (55%), low self-esteem, and low school performance. Parents of strabismic children believed that their love for their children is not affected due to crossed eyes (53%) and that strabismic children should not be taken to traditional healers (59%). Barriers faced during the management of strabismus are parents’ negligence (76%), fear of surgery (34%), and high cost (29%). Doctors are the most used and preferred source of information among parents of strabismic children.
Conclusion
This study identifies gaps in knowledge, wrong beliefs in society, and the barriers faced by parents of strabismic children. Thus, raising awareness of the importance of detecting and treating strabismus early, avoiding psychosocial complications, and improving children’s quality of life.
... A study conducted in Hail city, Saudi Arabia, showed that the prevalence of squint among 299 participants was 17.1%; however, the prevalence of squint is usually underestimated, often due to lack of awareness and detection. Family history, ethnicity, genetic conditions, smoking, prematurity, low birth weight, refractive error, and neuro disability are the most common risk factors associated with the development of strabismus" [21]. ...
Many patients with symptomatic eye conditions present initially to their primary care physician. Eye issues account for 2-3% of all primary care office visits. Knowing how to respond when these patients come is critical for the family physician, as is knowing when to refer them to an ophthalmologist for additional care. Family doctors should be able to spot eye disorders that can cause vision loss and necessitate an immediate referral to an ophthalmologist. A comprehensive history and physical examination are essential in reaching a diagnosis and determining the severity of the eye problem. Visual changes, length of symptoms, presence or absence of a foreign body, history of trauma or recent eye surgery, and concomitant symptoms such as a headache, nausea, or ocular discharge should all be addressed in the history. Almost 50% of all eye disorders presented to a family physician. Comprehensive treatment of such conditions can often be provided in the primary care setting. Patients with persistent or severe conditions, particularly those involving foreign bodies and corneal abrasions due to high-velocity injuries, should be referred for immediate care by an ophthalmologist. This review aims to review most prevalent eye complaints in primary health care centers in Saudi Arabia.
... Our analysis revealed that although conventional treatments, including eye patches, glasses, vision exercises, surgery, and contact lenses, continued to be the most popular treatment options, improvement in vision using emerging technologies was also mentioned. Symptoms and treatment options revealed by the posts were consistent with the current literature [10,19,20]. The main reasons for switch and lack of compliance to treatment options included worsening of vision, discomfort, bullying, and huge financial burden/insurance issues. ...
IntroductionAmblyopia is an important cause of monocular vision impairment worldwide, and it negatively impacts patients’ quality of life (QoL). Understanding patients’ perspectives may help to optimize treatment outcomes and improve treatment adherence.Methods
This was a non-interventional, retrospective analysis of social media data available in the public domain posted by patients and caregivers on selected social media channels (Twitter®, forums, blogs, and news) from 12 countries between July 2018 and June 2020.ResultsApproximately 2662 conversations relevant to the research objective were analyzed. The patient journey for adults and children was constructed based on the conversations. Eyeglasses, eye patches, contact lenses, and vision exercises were the common treatment options for amblyopia. Patients also reported vision improvement with emerging technologies such as digital therapeutics. Amblyopia and its treatment had a negative impact on QoL, and increased caregiver burden. Insurance coverage, long appointment waiting times, and recurring expenses of treatment options were reported as barriers to treatment. Non-compliance, switching between treatment options or technology, or discontinuation of treatment options was found to emanate from various issues including no improvement of the condition, discomfort with the treatment option, bullying, dissatisfaction with healthcare professional (HCP) recommendation, cost of treatment/issues with insurance coverage, side effects, and/or other unspecified reasons. The need for regular eye examinations, better diagnostic tests, awareness of the disease, awareness amongst HCPs about treatment options, and the need for better health insurance coverage policies emerged as unmet needs.Conclusion
This social media listening study generated insights on patients with amblyopia and their caregivers regarding the patient journey, treatment options, reasons for non-compliance, reasons for switching HCPs, barriers to treatment, and unmet needs. Further qualitative research is required to validate the findings.
