Esotropia

• Evaluations of eye alignment are a critical survival skill, as abnormalities can be a sign of serious, and occasionally life-threatening pathology. 

​

• Use the Hirschberg test or alternate cover test for these evaluations.

​

• The corneal light reflex, or penlight highlight, will appear on the lateral side of the pupil.

​

• Esotropia is documented as “ET,” or “E(T)” when intermittent.

​

• The magnitude of strabismus is measured in prism diopters.

​

Symptoms to look for:

• Diplopia, or double vision, is the symptom that most strongly suggests an abnormality of eye alignment, but it may not always be present (e.g. very young children often do not complain of diplopia, even when there is an acute onset of strabismus). ​

​

• The presence of strabismus without diplopia generally (but not always) suggests something more longstanding and less worrisome.​

​

• The presence of a habitual head tilt or face turn is suggestive of strabismus.​​

​

Remember:​

​

• Strabismus can be acquired, which is generally a bad thing. It suggests that something dysfunctional is going on with the brain, the cranial nerves controlling EOMs, the EOMs themselves, or occasionally the retina.