The endotropia is an eye condition that requires specialised care and early diagnosis to prevent long-term visual complications. This disorder, also known as convergent strabismus, affects both children and adults and can have a significant impact on the patient's quality of life if not properly treated.
What is endotropia?
The endotropia is a type of strabismus characterised by the inward deviation of one or both eyes. This condition causes the eyes to not align properly, deviating towards the nasal region, resulting in crossed eyes. Endotropia affects binocular vision and, in some cases, can lead to amblyopia (lazy eye).
This visual disturbance contrasts with exotropia, where the deviation occurs outwards. Endotropia can be present from birth or develop during childhood, with the most common form of strabismus occurring in the first 6 years of life.
What types of endotropia are there?
Specialists classify endotropia into different types according to its characteristics, causes and time of onset.
Congenital or infantile endotropia
Congenital endotropia appears in the first six months of life and is usually a severe condition. It presents with an angle of deviation greater than 30 prismatic dioptres and may manifest as monocular or alternating.
Accommodative Endotropia
Accommodative endotropia is related to uncorrected farsightedness. It develops progressively, usually after the age of 3 years, and is characterised by the fact that the constant effort to focus can lead to ocular deviation. It is usually corrected with the use of corrective lenses.
Acquired Endotropia
Acquired endotropia develops later, usually due to neurological problems, trauma or diseases affecting the muscles or nerves responsible for eye movement. The first symptoms appear between 2 and 3 years of age and the deviation may increase intermittently.
What are the causes of endotropia?
Endotropia may have a significant hereditary component. Siblings of children with accommodative endotropia have a high prevalence of developing amblyopia.
Untreated hyperopia can lead to accommodative endotropia. When farsightedness is present and optical correction is not used, the constant strain on the eyes can eventually force them into a crossed position.
Risk factors include prematurity, low birth weight, abnormal delivery and being born to a smoking mother. Prenatal exposure to drugs, including alcohol, and certain medications also increase the risk.
On the other hand, some diseases of the central nervous system can affect the control of eye movements. Other factors include diabetes, hyperthyroidism, genetic disorders such as Down's syndrome, and congenital eye defects.
Blows to the head or damage to the eye muscles can cause acquired endotropia. It can also be caused by weakness of the extraocular muscles due to various medical conditions.
How is endotropia treated?
Treatment of endotropia requires a personalised approach depending on the specific type, age of the patient and severity of the condition. In the Dr. Nebro Ophthalmological CentreWe have the most advanced technology and specialised equipment to offer the best therapeutic options.
Optical correction with glasses and contact lenses
For accommodative endotropia, the use of special glasses to correct refractive problems is essential. This reduces the accommodative effort, preventing the eyes from deviating. Contact lenses also represent an effective alternative in selected cases.
Surgical treatment
Strabismus surgery is mainly indicated in infantile or congenital endotropia, which should be operated on before the age of 18 months for best results. It is also used when correct eye alignment is not achieved despite the use of glasses or contact lenses.
Botulinum toxin
The application of botulinum toxin represents an effective therapeutic option, especially for cases of residual entropy after surgery. This treatment achieves a 75 % success rate in ocular alignment, with a very low risk of complications.
Patch therapy
Eye patching is part of comprehensive treatment, especially to prevent or treat associated amblyopia. This therapy helps to strengthen the weaker eye and improve binocular coordination.
Endotropia requires accurate diagnosis and timely treatment to prevent permanent visual complications. In our Ophthalmology ClinicWe have the most advanced technology available, including OCT Scanner and specialised diagnostic equipment, allowing us to offer a comprehensive approach from diagnosis to surgical treatment when necessary.