Ask Little Four Eyes: surgery for

This community is amazing and has a wealth of experience between all of us.  So “Ask Little Four Eyes” is your chance to ask the full community.  If you have a children’s glasses or vision-related question, submit it here and I’ll post it to the blog as well as the facebook page and group.  I’ll collect the responses and update the post with those responses.  – Ann Z.


I posted here before when i first found out my daughter has accomodative esotropia and needed glasses , that was 3 months ago. She is now 23 months and 3 weeks old. It was totally devastating for me at first, i spent so many days crying about it,  but still im glad we found about it early,.. anyway at first she screamed and threw it away every time I tried to put them on for her (thank goodness I bought the flexible type or she would have broken several glasses), and with lots of patience (and showing her kids wearing glasses in tv shows and several youtube videos) she started wearing them much longer than before, she takes them off several times a day but they are on most of the time.

Anyway, i still feel sad that she has to wear them at her age  (some people commenting that she is sooo young to wear glasses makes me feel upset) but I keep focusing on the main goal and that is glasses will make her vision improve.. slowly but surely.

The thing that bothers me is that when she started wearing her glasses her eye is moving inwards more than before when she takes them off, and I’ve read that it’s normal but I still wonder if I could get her to make an operation before becoming 10 yrs old to adjust the esotropia and keep wearing the glasses till fully healed? Anyone did that before? I just don’t want her to be subjected to anyone commenting on her esotropia when she enters school or hurting her feelings.

I’ll start by saying that I understand the desire to protect your daughter from unkind comments.  From your question, it sounds like the times your daughter crosses her eyes is when her glasses are off.  In my understanding, with those cases, surgery is not recommended.  She crosses her eyes to focus through her farsightedness.  If she had muscle surgery, it would mean that her eyes are over corrected when she wears glasses (which she’ll need to correct her farsightedness).  In our experience, as Zoe got older, she’s been able to hold her eyes straight, even when her glasses are off.

Others who have experience with this, please chime in… 


5 responses to “Ask Little Four Eyes: surgery for

  1. I will say that she sounds an awful lot like me as a child! I never had surgery (although my own son did have the surgery for accommodative esotropia when he was 1, and his eyes still cross without his glasses. The surgery isn’t meant to correct THAT, it’s to keep them from crossing when his glasses are on!) and I can remember two comments about my glasses in all of my life. Both of them were from peers who were likely more curious than cruel, and I don’t recall being very upset or affected by it (even though I was a very sensitive child). There are honestly SO many more kids in glasses these days that I don’t think it’s going to be as bad as you think it will, particularly since she’ll probably be WEARING her glasses most of the time she is with her peers. As an adult I wear glasses because otherwise I get a headache, but I can function without them completely fine as well. 🙂


  2. My daughter was diagnosed with accommodative esotropia and partially congenital esotropia at 4-5 months. We caught it very early as her right eye started to drift inward. She was given glasses and took to them pretty well right away. They didn’t help enough and we could see she was switching back and forth from eye to eye to see, never using both at the same time. At 18 months she had the surgery for strabismus. It was hard and very sad for us but the results have been amazing. At 25 months now she looks perfectly straight in her glasses 99% of the time and the doctor attributes the 1% inward turn at this time to the wide nose bridge, so not really a sight issue. When we take the glasses off for bath time she most definitely turns her eyes in to focus. Most people just say how adorable her little glasses are occasionally I get the question on how to they figure it out at her age aad know what her prescription is.


  3. My daughter also has accommodative esotropia. She was first diagnosed as a + 6, but her eye kept turning in with her glasses on and the doctors kept increasing her prescription. Within just over a year, she has increased to a +9.25 in both eyes. She just got new glasses last month and already her eye is turning in again with her glasses on. The doctor recommended patching in the morning, and has suggested surgery. I’m apprehensive as I’ve heard lots about over-correcting. Any thoughts?


    • All I can say is that when glasses and patching weren’t enough to keep my sons eyes straight, we had the surgery done and have had great results (it’s almost 4 years since the surgery and now all he needs are glasses to keep his eyes straight). You could always get a second opinion from a doctor about your non-surgical options, but there are lots of kiddos who have the surgery and don’t have problems with over-correction. But there are risks with any decision you make, so it’s good that you’re doing your research and asking around.


  4. Hi Jenn, I completely understand where you are coming from, I was actually worried about under correcting. When they do the surgery they loosen the inside muscles by the nose so if it’s a slight overcorrection they can tell you to take and leave the glasses off as a possible method of bringing them back in line. When they under correct you are stuck and have to do it again. My daughter got the maximum correction which is I believe 5mm maybe 6mm can’t remember off the top of my head. I read the textbook on the surgery and here is the link.

    Surgical Management of Strabismus – Eugene Helveston

    Took me a week but it really helped with the technical talk and asking the right questions about blood flow, correction amounts, intubation etc. I found it also helped the doctor explain his thoughts more thoroughly as well. Since my daughters surgery her eyes have remained in line but we do patch an hour a day alternating eyes to make sure she is using both. When they manually straighten the eyes you wouldn’t be able to tell if they are favoring so it’s important that we make her use both. I don’t know much about the prescription getting worse as our daughters has only gone from +6.25 to 7 recently but hasn’t changed as much as yours. Hope this helps, happy to answer any questions you have.


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