Excessive inward turning of one eye which is due to poor sensory integration of the focusing (accommodative) system and the eye teaming and alignment system of the two eyes (binocular vision).
Treatment of Accommodative Esotropia includes the use of corrective prescription lenses to align the eyes and often the eyes will spontaneously begin to work together (binocular vision and eye teaming). In other cases, eye patching and/or Vision Therapy will be necessary.
According to our expert eye doctors, Accommodative Esotropia should NEVER be treated with strabismus surgery as this can cause focusing problems when the patient gets older.
Amblyopia is the medical term for impaired vision in one eye that can not be corrected to 20/20 with the application of a prescription lens. This vision deficit occurs in the brain, not in the eyeball.
Current 21st century scientific research has established that the human brain can change at any age (neuroplasticity) and, also, that amblyopia can be successfully treated in older children and adults. Nevertheless, most eye doctors who practice today went to medical or optometry college before these new scientific discoveries were made and they continue to follow outdated theories regarding cut-off ages for the treatment of amblyopia. In other words, most eye doctors still maintain that amblyopia can not be successfully treated after a certain young age.
The eye doctors in this directory keep abreast of the latest vision and brain research and provide effective treatment programs for patients with amblyopia.
Binocular Vision (bi-n-ocular) is two-eyed vision. In normal human binocular vision, two eyes -- side-by-side in the front of the head -- send two separate images to the brain. These two separate inputs are then fused together IN THE BRAIN to make one unified 3D stereo image. The successful fusion of two eye views into one 3D image is also called 3D stereo vision or stereoscopic vision.
3D Stereo Vision -- which happens in the brain -- gives the viewer greater, more accurate perception of detail, color, volume, location, and depth (3D depth perception). With 3D depth perception, a person has a much keener sense of where he or she is in space in relation to others in the environment, especially in relationship to moving objects (spacial relationships).
Lack of binocular vision, therefore, can negatively impact 3D depth perception, sports coordination, driving safety, spacial judgement and memory, as well as organizational skills, and more.
In all types of strabismus, binocular vision is disrupted and loss of this visual/perceptual ability can contribute to spacial misjudgement and confusion.
A relatively common -- and also commonly undetected -- near vision disorder that makes seeing at close distances laborious and faulty. The two eyes struggle to maintain the inward eye teaming coordination and focus (convergence) that are required for successful reading, desk work, arts and crafts, and close viewing.
Estropia is the general term for the type of strabismus with an inward eye turn(s) or when one or both eye(s) deviate toward the nose. The inward eye deviation can be occasional (intermittent) or constant.
Esotropia is more common in infants and young children than exotropia. Treatment depends on age of onset, severity, and many factors.
The pediatric eye doctors listed here in our FIND A DOCTOR locator offer the full range of treatment options, including non-surgical therapies. Pediatric ophthalmologists are surgeons and generally do not offer non-surgical therapies.
Exotropia is the medical term for the type of strabismus in which the person as an outward eye turn(s). The same eye may deviate outward or both eyes can alternate in their outward deviation. The outward eye deviation can be noticeable occasionally (intermittently) or constantly.
The developmental optometrists listed here in our FIND A DOCTOR locator offer the full range of treatment options for esotropia, including non-surgical therapies. Pediatric ophthalmologists are surgeons and generally offer pharmaceuticals and surgery only as treatment options.
All types of strabismus can adversely affect eye teaming ability.
In normal healthy vision, the two eyes work and move together simultaneously as a coordinated team for single 3D stereo vision and two-eyed depth perception (with no double vision!). Eye teaming is an neurologically active process…the brain signals the eye muscles in order to coordinate eye movements and visual processing.
Eye patching does not help eye teaming problems because one eye is covered in patch therapy and, therefore, the coordination of the two eyes as a team is not being stimulated or reinforced. Healthy eye teaming with depth perception can be developed or retrained at any age with non-surgical Vision Therapy.
An outward eye turn that is occasional or alternating and might only occur when the person is ill, tired, anxious, stressed, etc.
Intermittent Exotropia is a type of strabismus, but in some cases it is a symptom of another common near vision condition called convergence insufficiency.
Intermittent Exotropia responds best to non-surgical Vision Therapy treatment. Strabismus eye muscle surgery is not recommended.
Our panel of expert eye doctors points out that we see with our brains, not our eyeballs. In other words, it is the brain and nervous system that signals and instructs the actions of the eye muscles. Therefore, strabismus surgery -- which is not brain surgery or brain training -- does not address the root cause of strabismus.
NOTE: surgery of any type should be co-managed between a primary care doctor and a surgeon. Co-management by a primary care doctor is recommended because the surgeon typically provides minimal or no pre- and post- surgical consultation or care. The surgeon simply performs the surgery.
Strabismus Surgery, when appropriate for a given condition, is more effective when primary care optometric co-management and Vision Therapy are part of the treatment plan.
The primary eye care optometrists in this directory provide the pre- and post- surgical co-management and care that is in the best interests of the patient.
Lazy Eye is the popular term for Amblyopia, but the general public often also uses this phrase to refer to all types of Strabismus as well. In other words, sometimes when a layman sees an eye turn, he or she might say, "lazy eye."
This is confusing because Strabismus and Amblyopia (lazy eye) are NOT the same medical and visual condition. Yes, Strabismus can sometimes cause Amblyopia, but they are still not the same condition and need different treatment plans.
Two eyes working together as a coordinated team, aiming at the same focal point with simultaneous timing, gives the viewer the added visual perception of the depth dimension. With 3D Depth perception, the viewer visually perceives three spatial dimensions of width, height, AND depth (x, y, and z).
3D Depth Perception also gives the viewer more accurate perception of detail, volume, solidity, color, spacial relationships, and location. Good depth perception makes hand-eye coordination much easier.
Strabismus, a binocular vision disorder, often leads to diminished or little depth perception.
If the two eyes do not aim at exactly the same visual target, two mismatching images are sent to the brain. Double Vision occurs when the brain can not fuse the two mismatching images into one unified 3D image AND, at the same time, does not suppress (block out) one of the mismatching images. The doubling effect means that the visual system (eyes, brain and body) is missing out on stereo fusion (stereoscopic vision) and 3D depth perception.
Double vision occurs in the brain, so eye muscle surgery (which is NOT brain surgery!) is not appropriate or successful treatment. There is no brain surgery that helps double vision either, because single 3D vision is created by the coordinated effort of many regions of the brain. Vision therapy trains and/or rehabilitates the brain and is, therefore, the effective way to turn double vision into single 3D vision.
Double vision can be a symptom of binocular vision disorders, such as Strabismus or a related condition called Convergence Insufficiency.
Duane's Syndrome is a type of Strabismus which demonstrates various symptoms: inability to move an eye laterally away from the nose (palpebral fissure), retraction of the eye with close viewing or when one looks toward the nose; and inward eye turn with distance viewing. It can be confused with paralysis of an eye muscle (lateral rectus) and that can lead to a referral for an unnecessary neurological evaluation.
Surgery should not be performed unless there is a cosmetic problem when looking straight ahead and the patient desires cosmetic benefits only. The eye muscle surgery will not change the brain and improve vision. In some case, a better solution can be prescription prism eyeglasses. Some patients with Duane's Syndrome have secondary eye convergence problems which are effectively helped by Vision Therapy.
The facial characteristics of infants and young toddlers can sometimes create the appearance of an inward eye turn or crossed eye when, actually, the two eyes are aligned and healthy. Nevertheless, it is recommended that all children receive their first complete eye examination at six months of age to rule out amblyopia or other eye disorders. Pediatricians are not trained to give adequate or complete eye/vision examinations.
Described as physical therapy for the visual system (brain, eyes, body), Vision Therapy is effective non-surgical therapy or neurological training for many visual conditions, including most types of Strabismus and their related conditions, such as Lazy Eye, Convergence Insufficiency, Eye Tracking and Eye Teaming problems, Esophoria, Exophoria, etc.
FIND AN EYE DOCTOR - Strabismus and Amblyopia (Lazy Eye) Treatments
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