Question
A 4-month-old child has had left eye esotropia since birth. Do they need treatment?
Answer
For asymptomatic accommodative esotropia, since children have strong fusion and convergence abilities, no treatment may be necessary. However, for children with symptoms of visual fatigue due to accommodative esotropia, appropriate treatment can be considered. Internal esotropia requires dilation and prescription of glasses, and for myopes, appropriate glasses should be worn. External esotropia can be corrected by strengthening the strength of the medial rectus muscles through training. If the effect is not satisfactory, prism glasses can be used. For intermittent esotropia, dilation and refraction should be performed, and sufficient downward prism glasses should be worn to usually completely correct it. For children with intermittent exotropia, strabismus and binocular function tests should be conducted to evaluate their binocular vision function. If binocular vision function has not been lost, early surgical treatment should be considered. If the degree of strabismus is small, one can try wearing minus lenses and training, but this can only alleviate symptoms and is not easy to self-heal. In daily life, it is wished that the child stays healthy and intelligent.