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Was Diagnosed With Decompensated Esotropia With A Degree Of Divergence

Posted on Mon, 9 Sep 2019

Question: was diagnosed with decompensated esotropia with a degree of divergence insufficiency in my eyes. had thyroid function test and MRI of brain and orbits. All normal. prescribed prism glasses and are working for me. my questions are: can eye muscle surgery cure this condition? can eye exercises help? and can smartphone use cause this condition? im extremely near sighted and even with my glasses feel like i need to hold phone close to me to read. i heard excessive phone use can cause esotropia. is this correct? im scared that i cAused this condition! im a 48 yr old female.

Answered by Dr. Harshita (1 hour later)

Brief Answer:
Not neccearily phone use will cause esotropia

Detailed Answer:
Hey thanks for the question . Decompensated esotropia can be due to your refractive error and we usually don’t do surgery if the glasses help the patient . But obviously if the degree is esotropia is increasing or muscle is becoming more dysfunctional we do surgery . You need to work with your squint specialist regarding that. Regarding exercises well yes they help in esotropia . There are many vision programmes that can be done on a computer screen like home vision therapy . Besides that eye roll excercises and even synaptophore( an instrument available with any ophthalmologist) will also help you.Hope my answer helps you . If you have any follow up questions please do ask. Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Harshita (6 hours later)

What do u mean the esotropia May be due to refractive error? Does that mean myopia? I never had an eye turn as a child. It only started one year ago when I started to experience double vision. No one has been able to tell me the cause either. So when I read an article about excessive smart phone use making children cross-eyed, I am now wondering if reading on my phone caused this. Like I said, I have trouble reading sometimes even with my reading glasses and have to take them off to read fine print on the screen.

Answered by Dr. Harshita (26 minutes later)

Brief Answer:
Excessive XXXXXXX use has not shown to cause esotropia per se

Detailed Answer:
Hey thanks for the follow up. Myopia is a known etiology for it dear but excessive XXXXXXX use can cause dry eye and increased astigmatism but not esotropia per se . Did anybody do your Hess charting to find out any nerve involvement ? If possible could you share your examination results with us so we can tell you even better. As we age the power for near vision will increase with everybody and that power is usually in plus . As you already have a minus number aka myopia by removing your spectacles you are able to read the fine print as plus minus is zero. This is the reason many myopia patients don’t need glasses for near and get by by removing the spectacles while reading fine print . Hope my answer helps you . I would love to follow up .Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Harshita (1 hour later)

Brief Answer:
You have divergence insufficiency aka eyes don’t go outwards much

Detailed Answer:
Thanks for the question.

I went through your detailed reports. Thank you for sharing.

You have divergence insufficiency where eyes cannot go outwards much and as all your reports are normal so it is the primary type of DI.

For that base out prisms, Orthoptic exercises are best but surgery can be tried. The good news is that primary forms of the disease won’t progress rapidly at all and doesn’t need surgery usually.

There is no proven known cause of it but I have read a case series where they said that it could be due to degeneration of orbital connective tissues with age. I advise you to continue with prisms.

Hope my answer helped you.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Harshita (3 minutes later)

written assessment by my eye doctor attached for your review

Answered by Dr. Harshita (16 minutes later)

Brief Answer:
Glad to help you

Detailed Answer:
Hey, don’t worry.

I am sure prisms will keep on working for you and maybe you won’t even need surgery.

But do go for follow-ups once in a while.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Harshita (12 minutes later)

Thanks. U have been very helpful. I guess I will just stick with prism glasses as I am scared to do eye muscle surgery. One of the 5 doctors that I saw said surgery is not always successful for the type of esotropia that I have and that there is a risk of overcorrection- causing exotropia. That would be worse than what I have and I don’t want to take the risk unless prisms stop working altogether for me.