GeneHealth - Your precision medicine

Accommodative Esotropia

Disease Details

Family Health Simplified

Buy Membership

Description: Accommodative esotropia is a form of strabismus where one or both eyes turn inward due to the effort of focusing on near objects.
Type: Accommodative esotropia is a type of strabismus (misalignment of the eyes) that occurs primarily due to the focusing efforts required to see clearly. The specific type of genetic transmission for accommodative esotropia is not well-defined. It is generally considered to be multifactorial, meaning a combination of genetic and environmental factors contribute to its development. Family history can play a role in increasing the risk, but there is no single Mendelian pattern of inheritance.
Signs And Symptoms: **Accommodative Esotropia**:

**Signs and Symptoms:**
- **Eye Misalignment**: Inward turning of one or both eyes, especially when focusing on close objects.
- **Double Vision**: Possible diplopia, especially if the condition is intermittent.
- **Eye Strain**: Reports of tired or strained eyes.
- **Headaches**: Particularly after activities that require focusing, such as reading.
- **Squinting**: Child may squint or close one eye when focusing.
- **Decreased Depth Perception**: Difficulty judging distances accurately.
- **Amblyopia**: A risk of developing lazy eye if the condition persists untreated.

The management of this condition often involves corrective lenses to reduce the focusing effort and, in some cases, vision therapy or surgery. Regular eye exams are crucial for monitoring and adjusting the treatment plan.
Prognosis: Accommodative esotropia typically has a good prognosis, especially when identified and treated early. Management often includes corrective lenses, such as glasses with a bifocal segment or contact lenses, to address the focusing issues that contribute to the eye misalignment. In some cases, additional treatments like vision therapy or, rarely, surgery may be needed. With proper treatment, many individuals can achieve good binocular vision and alignment. Regular follow-ups with an eye care professional are essential to monitor the condition and adjust treatment as needed.
Onset: Accommodative esotropia typically has an onset between the ages of 2 and 3 years old. It occurs when the eyes turn inward due to a high degree of farsightedness (hyperopia) that causes the eye muscles to overcompensate while focusing.
Prevalence: The prevalence of accommodative esotropia is roughly 2% among children. It is a common form of strabismus, where one or both eyes turn inward, often associated with hyperopia (farsightedness). It typically becomes apparent in children between the ages of 2 and 5.
Epidemiology: For accommodative esotropia:

- **Epidemiology**: Accommodative esotropia is a form of strabismus commonly diagnosed in children, typically between the ages of 2 and 3. It is more prevalent among individuals with hyperopia (farsightedness) and those with a family history of strabismus or other vision disorders. The condition is estimated to affect about 2-3% of the pediatric population.

- **Nan**: It appears that "nan" is not a standard abbreviation or term in medical literature related to accommodative esotropia. Please clarify or provide additional context for accurate information.
Intractability: Accommodative esotropia is generally not considered intractable. It is a form of strabismus that can often be managed or corrected with appropriate treatments, such as prescription eyeglasses (with or without bifocals), vision therapy, or, in some cases, surgery to realign the eyes. Early diagnosis and intervention are key to effective management and successful outcome.
Disease Severity: Accommodative esotropia is typically not assigned a singular "disease severity" rating like some other conditions might be, as it varies based on individual circumstances. It predominantly affects children and involves the misalignment of the eyes due to focusing efforts.

The severity can depend on factors such as the degree of esotropia (inward turning of the eyes), the child's age at onset, and how well their vision improves with corrective measures like glasses or bifocals. In many cases, it can be well-managed with appropriate treatment, which can significantly reduce the impact on vision and quality of life.
Healthcare Professionals: Disease Ontology ID - DOID:9839
Pathophysiology: Accommodative esotropia is a form of strabismus (eye misalignment) where one eye turns inward, typically due to efforts to focus (accommodate) closely. The pathophysiology involves a high degree of hyperopia (farsightedness). When a person with significant hyperopia tries to focus on near objects, they exert excessive accommodative effort, triggering an overactive convergence response in the eyes. This over-convergence leads to one eye turning inward, resulting in esotropia. The condition often becomes noticeable in early childhood and can be managed effectively with corrective lenses or, in some cases, surgery.
Carrier Status: Accommodative esotropia is not a condition that involves carrier status as it is not caused by a single gene mutation that can be inherited in a straightforward manner. It is a type of strabismus (eye misalignment) where one eye turns inward, typically due to focusing efforts or hyperopia (farsightedness). The condition is primarily influenced by visual and refractive factors rather than genetic carriers.
Mechanism: ### Mechanism
Accommodative esotropia is a type of strabismus (misalignment of the eyes) characterized by an inward turning of one or both eyes when focusing on a near object. The condition is associated with hypermetropia (farsightedness), where excessive accommodating (focusing) effort is needed to see clearly. This increased accommodation leads to a corresponding increase in the convergence of the eyes, which can result in esotropia. The condition typically manifests in early childhood and can be intermittent or constant.

### Molecular Mechanisms
The molecular mechanisms underlying accommodative esotropia are not fully understood. However, it involves complex interactions between genetic, neurophysiological, and optical factors:

1. **Genetic Factors**: There is evidence suggesting a hereditary predisposition to accommodative esotropia. Specific gene mutations or polymorphisms may influence the development of refractive errors like hypermetropia and the neuronal mechanisms controlling eye alignment.

2. **Neurophysiological Pathways**: The neural mechanism involves the brain's coordination of accommodating (focusing) and converging (eye-turning) mechanisms. Signals from the retina to the brain and then to the extraocular muscles must be precisely coordinated. Dysregulation in these pathways can lead to excessive convergence while accommodating.

3. **Optical Factors**: Anomalies in the refractive components of the eye, such as the cornea and lens, contribute to hypermetropia that necessitates increased accommodative effort. This increased effort triggers overactive convergence responses in genetically or neurophysiologically predisposed individuals.

In summary, accommodative esotropia is primarily driven by the interplay of higher accommodative demand due to hypermetropia and the resultant excessive convergence response, with genetic predispositions and neurophysiological controls playing contributory roles.
Treatment: The prognosis for each patient with esotropia will depend upon the origin and classification of their condition. However, in general, management will take the following course:

Identify and treat any underlying systemic condition.
Prescribe any glasses required and allow the patient time to 'settle into' them.
Use occlusion to treat any amblyopia present and encourage alternation.
Where appropriate, orthoptic exercises (sometimes referred to as Vision Therapy) can be used to attempt to restore binocularity.
Where appropriate, prismatic correction can be used, either temporarily or permanently, to relieve symptoms of double vision.
In specific cases, and primarily in adult patients, botulinum toxin can be used either as a permanent therapeutic approach, or as a temporary measure to prevent contracture of muscles prior to surgery
Where necessary, extra-ocular muscle surgery, like strabismus surgery, which is a surgery where the doctors physically move the muscle that is making the eye contract. This can be undertaken to improve cosmesis and, on occasion, restore binocularity.
Compassionate Use Treatment: Accommodative esotropia is a form of strabismus characterized by an inward turning of one or both eyes that is typically related to focusing efforts (accommodation). Treatment traditionally includes prescription glasses, bifocals, or contact lenses to correct the refractive error. However, in cases where traditional treatments are insufficient or not viable, alternatives may be explored.

### Compassionate Use Treatment
Compassionate use, also known as expanded access, allows the use of investigational drugs outside of a clinical trial for patients with serious or immediately life-threatening conditions when no comparable or satisfactory alternative therapy options are available. For accommodative esotropia, compassionate use is generally not applicable because this condition is not typically life-threatening.

### Off-Label or Experimental Treatments
- **Botulinum Toxin Injections**: Occasionally, botulinum toxin injections into the medial rectus muscle have been explored as an off-label treatment for strabismus, including accommodative esotropia, to temporarily weaken the muscle and reduce the inward turning of the eye.
- **Atropine Drops**: Atropine eye drops may be used off-label to blur vision in the non-preferred eye, which encourages the use of the weaker eye and can help in realigning the eyes.
- **Prism Glasses**: Prisms are sometimes used in spectacles to help with the alignment of vision, reducing the effort required for accommodation.
- **Vision Therapy**: Although not universally accepted, vision therapy involves exercises and activities designed to improve ocular alignment and coordination. This approach is considered experimental by some ophthalmologists and optometrists.

It is important to consult with a specialist in pediatric ophthalmology to determine the most appropriate, evidence-based treatment options for accommodative esotropia.
Lifestyle Recommendations: For accommodative esotropia, which is a type of strabismus where one or both eyes turn inward, certain lifestyle recommendations can help manage the condition:

1. **Regular Eye Exams**: Regular follow-ups with an eye specialist are crucial to monitor the condition and adjust treatments as needed.
2. **Corrective Lenses**: Wearing prescribed glasses or contact lenses can help correct vision and reduce the inward turning of the eyes.
3. **Patching**: Covering the stronger eye for a few hours each day can help improve the weaker eye’s strength and coordination.
4. **Vision Therapy**: Specialized exercises can improve eye coordination and focusing skills.
5. **Healthy Diet**: A diet rich in vitamins and minerals, particularly Vitamin A, C, and E, can support overall eye health.
6. **Adequate Lighting**: Ensuring good lighting while reading or doing close-up work can reduce eye strain.
7. **Limit Screen Time**: Reducing screen time and taking regular breaks when using digital devices can ease eye strain.
8. **Encourage Outdoor Activities**: Spending time outdoors can benefit overall eye health and reduce the risk of developing eye issues associated with prolonged near tasks.

Following these recommendations can help manage accommodative esotropia more effectively and improve vision outcomes.
Medication: Accommodation esotropia is typically managed through non-surgical means such as corrective lenses (glasses) or sometimes bifocals. These interventions help to reduce the focusing effort needed for clear vision, which in turn can alleviate the eye crossing. In some cases, orthoptic exercises may be recommended. Medications are generally not a primary treatment for accommodative esotropia. Injectable medications like botulinum toxin may be considered in specific cases under specialist advice. Always consult an eye care professional for an accurate diagnosis and appropriate treatment plan.
Repurposable Drugs: Accommodative esotropia is a type of strabismus (eye misalignment) that arises due to a high degree of farsightedness (hyperopia). The primary treatment generally includes prescribing corrective eyeglasses to reduce the eye's focusing effort and thus correct the alignment. There are no specific drugs approved solely for the treatment of accommodative esotropia. However, atropine eye drops, typically used for other eye conditions, can sometimes be repurposed to manage associated conditions like amblyopia (lazy eye) that may arise in conjunction with accommodative esotropia.
Metabolites: Accommodative esotropia is a type of strabismus (misalignment of the eyes) where one or both eyes turn inward, particularly when attempting to focus on close objects. It does not directly involve specific metabolites but rather is related to issues with the eye's focusing mechanism. Therefore, the term "metabolites" is not applicable in the context of accommodative esotropia.
Nutraceuticals: Accommodative esotropia is an eye condition where one or both eyes tend to turn inward, especially when trying to focus on an object. This condition is primarily managed with vision correction methods such as glasses or contact lenses, possibly combined with vision therapy. Nutraceuticals, which are products derived from food sources that offer health benefits, are not typically used in the standard treatment of accommodative esotropia. The management focuses on addressing the refractive error and helping to align the eyes.
Peptides: Accommodative esotropia is a form of strabismus (eye misalignment) where one eye turns inward, typically occurring due to focusing efforts in people with hyperopia (farsightedness).

Peptides: No specific peptides are currently known to directly address or treat accommodative esotropia. Treatment usually involves optical correction, such as wearing glasses with the correct prescription, which reduces the effort needed to focus and thereby minimizes the inward turn of the eye.

Nan: There is no significant connection between nanotechnology and the treatment or management of accommodative esotropia. Standard treatments are primarily optical and sometimes involve vision therapy or, in more severe cases, surgery.