Esodeviations and Associated Syndromes

Abstract

Esodeviations refer to misalignments where one or both eyes are turned toward the nose. Various factors contribute to this misalignment, such as disorders in horizontal rectus muscles, refractive errors, and accommodative convergence. The classification of esotropia is based on manifestations, accommodation issues, and consistency with gazes. Latent deviations, termed esophoria, arise due to weak fusional amplitudes and become apparent when fusion is disrupted. Intermittent esotropias manifest under stress or fatigue. Constant esotropias are categorized by comitance, with comitant esotropias involving constant deviation in all gaze directions, likely caused by refractive or accommodative problems. Incomitant esotropias, prevalent in lateral rectus paralysis or medial rectus entrapment, also occur in conditions such as Duane's retraction syndrome, Mobius syndrome, and heavy eye syndrome. Abducent Nerve Palsy arises from damage or dysfunction of the sixth cranial nerve, leading to weakness or paralysis of the lateral rectus muscle. Duane syndrome, a congenital eye movement disorder, restricts eye movement, especially outward, and Moebius syndrome, a rare congenital disorder affecting cranial nerves, results in difficulties with eye coordination. Treatment for esodeviations varies based on the underlying cause and severity, including options such as vision therapy, glasses, prisms, botulinum toxin injections, or surgery to correct muscle imbalances and enhance eye alignment.