Concerned moms have similar vision questions about Accommodative Esotropia

Courtesy of Pediatric Ophthalmic Consultants

Yesterday, I had three interesting and completely separate inquiries in to an eye condition that is often detected at home (usually by mom) at a very young age.  My first question came from Kim, an elementary school classmate that I had connected with on Facebook after many years.  She is concerned because she is noticing that her three-year old daughter’s left eye has been crossing lately.  Kim’s also noted her running in to things and seeming clumsy.  A good eye exam will help gain a better understanding of why it’s happening.

The next interaction was with Adelyne,another young girl that had been in for her first eye exam after having trouble at a school vision screening.  She could tell that one eye was worse than the other and sure enough her left eye was twice as bad as her right.   She had been having difficulty with reading and headaches and I prescribed her glasses to correct the varied amount of farsightedness in her eyes.   Today’s visit was a six-week follow-up to see how she was doing and to see if patching her good eye would be helpful.  We decided to start patching therapy and see her back in three months to check her progress.  I recommended “active” activities such as iTouch games, Word Finds and drawing/coloring as opposed to “passive” activities such as sitting around and watching television.

I had my last encounter when I was going to pick up my daughter at a friend’s house as the day was winding down.  After a quick hello, mom expressed concern over noticing that one of little brother’s eyes seems to be turning in excessively when he’s looking at his food.  In addition to that, he’s closing that same eye at times while reading.  Following a discussion on what I think could be happening, I recommended that it was time for him to have an eye exam too.

Although these cases weren’t exactly alike, they all point to symptoms experienced when one eye is much stronger (or weaker) than the other.  A common diagnosis when we see this is accommodative esotropia.

Courtesy of

This condition is an inward turning of an eye as one is trying focus up-close or “accommodate” on a near target of some kind.  As the child is trying to overcome the farsightedness, he or she loses binocular control of the muscles that keep our eyes aligned.  At that point, one eye over-converges or crosses.  This condition can often be corrected with glasses alone, but sometimes requires patching and perhaps vision therapy.

There is a very good blog for parents of children diagnosed with similar eye conditions called  Ann Z. has done a great job of creating a community for those with little ones wearing glasses.  Always an interesting, fun read!

Kudos to the moms for reaching out to me for help.  I hope they get a good accurate diagnosis soon!

In other EyeWorks news, we have our first video testimonial from one of our first patients at the VisualEyes Therapy Center.  Click here to watch the video.  Let me know if you have any questions!

About admin

Eye/vision doctor in San Antonio. Serious sports fan. Goofy dad. Husband who tries hard. Never met a bag of beef jerky that I didn't like. Except salmon. San Antonio, TX ·
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  • I had no idea why eyes crossed in the first place. Who knew that sometimes an eye can be “overactive” or too strong. Hmm. Thanks for the info!