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Q&A with Dr. Mitchell: Blog 8

Q: I’ve noticed that my child has a eye turn. What can be done about that?

0086930001557848042.jpgA.  An “Eye Turn” can be a fairly common condition seen in an optometrist’s office.  Tropia and phoria are medical terms used to describe eye turns.  A tropia is a turn or misalignment that is always present.  A phoria is a misalignment that occurs intermittently.  Every person’s eyes have a resting phoric position (a position the eyes turn to when not being used).  Some people have a larger resting phoric position that they must overcome or compensate for.  This is all done automatically and is usually not something a person can control.  The terms eso and exo refer to whether the eye is turned in (eso) or out (exo).  Several things can cause the eye to be misaligned.  Tropias pose the greatest risk to vision.  If the eyes are not aligned, the brain has two options:  See single and “switch off” the misaligned eye; or see double. "Switching off" is problematic in children as the connection between the brain and eye is formed by using the eye.  The eye and the brain “learn” to see.  If the eye isn’t being used, clear 20/20 vision may not form.  Uncorrected refractive error (typically faresightedness) is very common in eyes that are either esophoric or esotropic.  If a muscles that controls the eye (there are six per eye) are over or under acting,  a phoria or tropia can usually be seen.  All the causes of eye turns are too numerous to name in this blog, but most can be treated fairly easily.  Treatment can sometimes be as simple as a pair of glasses or contact lens.  Sometimes, further treatment is needed in the form of prism in the glasses, to push the image towards the eye turn.  In other instances, surgery is required to completely correct the misalignment.  If you are concerned about a possible eye turn, it’s always a good idea to have it checked out, especially in young children. Also, if you have an eye turn after a traumatic event, it needs to be checked immediately.  

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