Fully accommodative esotropia is the proper term for a convergent squint that is completely controlled with glasses. In this situation your child will wear glasses and his/her eyes will be straight but when he/she takes the glasses off their eyes will turn together. Sometimes the glasses are required just to correct the squint but most often they are also used to improve vision and the majority of children wearing glasses from the age of three is not a big issue. Without the glasses on the squint will be noticeable. This will occur at times when the glasses are removed such as outdoor play or going to bed. It will also be seen when your child goes swimming although wearing a prescription pair of goggles will help to keep the eyes straight.
Sometimes the convergent squint causes visual problems and is not simply a cosmetic issue but also a functional one. Sometimes squinting children have a delay in reading and consequently it is important to try and assess these children early on. Children should have a test for glasses from the age of three. Normal eye test at school happens in reception year and some cases this will be done after the age of five. In children who have a potential weak eye because of a difference in refraction (need for glasses) this will mean that there is a two year delay after which a child could have been seen to when they are seen at school.
It is not possible to do an operation to correct fully accommodative esotropia. If that is the case and children require glasses to see, they could have an operation to straighten their eyes for when they have their glasses off but as soon as they put their glasses on their eyes will turn outwards which is a far more of a cosmetic issue than eyes turning in.
PARTIALLY ACCOMODATIVE ESOTROPIA
This is the proper term in whom glasses partially correct convergent squint. In these cases if there is a cosmetic issue or functional issue in the way the squint persists despite wearing glasses. The child might benefit from squint surgery to correct that element of the squint that is not corrected by glasses.
NON ACCOMODATIVE ESOTROPIA
This is the proper term for children who have a convergent squint that is not related to their need for glasses in any way. In these children, they often have a weak prescription in their glasses and wearing the glasses makes no difference to the angle of squint. These children almost inevitably require surgery to re-balance their eyes.
