What Is Esotropia?

Medically Reviewed by Jabeen Begum, MD on November 09, 2021

Esotropia, also known as strabismus, is an eye misalignment that causes one or both eyes to turn inward. The condition may occur in one or both eyes or alternate between the two. It's often referred to as being "cross-eyed." Esotropia is most common in babies and children, but can occur at any age. 

Esotropia typically appears in babies and young children who are younger than age 3. However, it can occur suddenly in older children or adults. If you or your child suddenly develop blurry vision or start seeing double, call your doctor. It could be a result of a neurological problem. 

What Are the Types of Esotropia?

There are two main types of esotropia:

  • Accommodative esotropia. This often occurs if you're farsighted and don't have corrective lenses, like contacts or reading glasses. You may have to work harder to focus and keep images clear. This can cause one or both eyes to turn inward. You may see double, or have to close or cover an eye to focus. 
  • Intermittent esotropia. When the eyes are unable to work together, it's called intermittent esotropia. Your eyes may focus past the object you're trying to see. Symptoms include headaches, eye strain, and difficulty reading. 

What Causes Esotropia?

Esotropia is a result of problems with the eye muscles, nerves that send information to those muscles, or the part of your brain that controls eye movements. It can also occur after an eye injury. 

Risk factors include‌: 

  • Genetics or family history. If your parents or siblings have esotropia, you're more likely to develop it.
  • Uncorrected farsightedness. Some people who are significantly farsighted, a condition called hyperopia, may develop esotropia from overfocusing. 
  • Other medical conditions. Esotropia can occur in people with cerebral palsy or Down Syndrome.

Lazy eye is known as alternating esotropia. This occurs when one eye fixates on an object, but the other doesn't. One eye moves but the other takes longer to adjust. Surgery can help fix this condition. 

Esotropia can also appear after a stroke. 

What Are the Symptoms of Esotropia?

‌Symptoms of esotropia include:  

  • Misaligned eyes
  • Eyes that can't move together
  • Constant squinting or blinking 
  • Depth perception issues
  • Tilting or turning the head to see objects more clearly
  • Double vision 

See your doctor, or make an appointment for your child, if you notice any of these symptoms. Your provider will examine the general health of your eyes, note any vision changes, and check your visual acuity, which is a measure of how far you can see. 

What Are the Treatments for Esotropia?

If discovered early, this condition is easier to treat. Esotropia treatments include: 

  • Corrective lenses, like eyeglasses or contacts 
  • Prism lenses that are thicker on one side to reduce the amount of light entering your eye
  • Vision therapy, which includes exercises to improve focus and eye coordination 
  • Surgery to straighten the position or length of your eye muscles 

Depending on the severity of your esotropia, your provider may also prescribe ointments, or eye drops to help straighten the eyes. 

Undiagnosed esotropia can be caused by more serious health problems, like undiagnosed brain tumors or neurological disorders. 

Are There Risks of Esotropia?

Without treatment, esotropia will continue to get worse. Children with any form of this condition should see a doctor or eye specialist, especially if they develop symptoms after age 3 or 4. Esotropia that isn't corrected before age 9 can cause permanent vision loss. 

If the eyes aren't aligned, it can lead to other problems, including: 

  • Blurry vision that affects daily activities
  • Eye fatigue and strain
  • Headaches
  • Double vision 
  • Poor 3-D vision 

Show Sources


American Association for Pediatric Ophthalmology and Strabismus: "Esotropia." 

American Optometric Association: "Strabismus." 

Cleveland Clinic: "Strabismus (Crossed Eyes)." 

Mayo Clinic: "Strabismus: The importance of timely, specialized care." 

Stanford Health Care: "Causes and Risk Factors for Lazy Eye." 

University of Michigan Kellogg Eye Center: "Esotropia." 

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