ACCOMMODATIVE ESOTROPIA: CROSSED EYES "FIXED" WITH GLASSES
Your child has been found to have eyes that cross and your pediatrician/ophthalmologist feels that glasses will help this crossing.
What causes this condition?
If a child is farsighted, the eyes are not in focus. There is a lens inside the eye which changes the eyes' focus. We normally use this lens to focus of things close up, however, when a child is farsighted, this lens must be used constantly. Whenever this lens is used, when we focus our eyes to improve vision in farsightedness, the eyes cross.
Focusing is linked to crossing much like pedling a bicycle turns the wheels. After a full evaluation by the ophthalmologist, glasses can be prescribed which should help if not completely treat the crossing.
Do glasses or contact really fix this?
When the glasses are in place, the eyes should not cross. Whenever the glasses are taken off, the child's eyes may cross. This may be because your child is accustomed to seeing things clearly with the glasses on and has to strain to see clearly and focus hard with them off. This means that if your child looks over the glasses or takes the glasses off, the eyes will continue to cross. It is important for you to realize that the glasses help your child to see clearly and without the glasses, your child has to strain to see things. The glasses relieve the need to focus which causes the crossing of the eyes. It is not caused by reading in dim lights or sitting close to the television. Your child may outgrow the farsightedness and crossing of _________ ______________. Many children will need glasses or lenses for life.
Will contact lenses work?
Yes, contact lenses will usually work as well as glasses. Contact lenses are more expensive and demand more attention than glasses. When children become adolescents, they are often willing to undertake the responsibility for handling the contact lenses.
Why not just fix this with an operation?
The crossing is a symptom of the farsightedness. If we fixed the crossing without fixing the farsightedness then your child's eyes would turn out when the lenses are worn. Often, children who are farsighted can go without lenses for a few years but they eventually need the lenses to read as they get older. IF we straightened a three year old child's eyes without fixing the farsightedness, the eyes would turn out when the child is older and needed the lenses for school work.
Are there any special tricks to get my child used to wearing the glasses?
The best start is with support and encouragement. Your child may honestly tell you that he/she does not see any better or that vision is initially worse with the glasses on. This is because your child has not been used to relaxing the focusing muscles in their eyes. If your child continues to say that the vision is blurry with the glasses on, then your pediatrician/ophthalmologist can prescribe some drops which can help your child get used to the glasses. The glasses should be worn during all waking hours. This means that they should be removed at night, but they do not necessarily have to be removed during naps. When they are removed at bath or bed time, you may notice the eyes cross.
These are all questions that families ask when a child is thought to have accommodative esotropia. Hopefully this pamphlet will help you to better understand this condition as well as answer these questions. Keith S. Morgan, M.D.
Your child has been found to have eyes that cross and your pediatrician/ophthalmologist feels that glasses will help this crossing.
What causes this condition?
If a child is farsighted, the eyes are not in focus. There is a lens inside the eye which changes the eyes' focus. We normally use this lens to focus of things close up, however, when a child is farsighted, this lens must be used constantly. Whenever this lens is used, when we focus our eyes to improve vision in farsightedness, the eyes cross.
Focusing is linked to crossing much like pedling a bicycle turns the wheels. After a full evaluation by the ophthalmologist, glasses can be prescribed which should help if not completely treat the crossing.
Do glasses or contact really fix this?
When the glasses are in place, the eyes should not cross. Whenever the glasses are taken off, the child's eyes may cross. This may be because your child is accustomed to seeing things clearly with the glasses on and has to strain to see clearly and focus hard with them off. This means that if your child looks over the glasses or takes the glasses off, the eyes will continue to cross. It is important for you to realize that the glasses help your child to see clearly and without the glasses, your child has to strain to see things. The glasses relieve the need to focus which causes the crossing of the eyes. It is not caused by reading in dim lights or sitting close to the television. Your child may outgrow the farsightedness and crossing of _________ ______________. Many children will need glasses or lenses for life.
Will contact lenses work?
Yes, contact lenses will usually work as well as glasses. Contact lenses are more expensive and demand more attention than glasses. When children become adolescents, they are often willing to undertake the responsibility for handling the contact lenses.
Why not just fix this with an operation?
The crossing is a symptom of the farsightedness. If we fixed the crossing without fixing the farsightedness then your child's eyes would turn out when the lenses are worn. Often, children who are farsighted can go without lenses for a few years but they eventually need the lenses to read as they get older. IF we straightened a three year old child's eyes without fixing the farsightedness, the eyes would turn out when the child is older and needed the lenses for school work.
Are there any special tricks to get my child used to wearing the glasses?
The best start is with support and encouragement. Your child may honestly tell you that he/she does not see any better or that vision is initially worse with the glasses on. This is because your child has not been used to relaxing the focusing muscles in their eyes. If your child continues to say that the vision is blurry with the glasses on, then your pediatrician/ophthalmologist can prescribe some drops which can help your child get used to the glasses. The glasses should be worn during all waking hours. This means that they should be removed at night, but they do not necessarily have to be removed during naps. When they are removed at bath or bed time, you may notice the eyes cross.
These are all questions that families ask when a child is thought to have accommodative esotropia. Hopefully this pamphlet will help you to better understand this condition as well as answer these questions. Keith S. Morgan, M.D.
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