There’s the woman who thought the reason her young child’s eye was turning inward was “cross eyes” but it turned out to be a brain tumor.
“One eye drifting in is called esotropia,” says Kaushal M. Kulkarni, MD, board certified ophthalmologist and neuro-ophthalmologist in private practice in New York.
Dr. Kulkarni explains, “It may occur intermittently or be constant and may occur when looking up close, far away or both. The crossing may happen in only one eye or may alternate between eyes.”
In infants who are under the age of 20 weeks, esotropia will often resolve on its own.
This is particularly true when the misalignment of their eyes is periodic and mild in degree.
“However, constant eye crossing at any age should be evaluated promptly by an ophthalmologist, especially if it happens suddenly,” says Dr. Kulkarni.
“If one eye suddenly drifts inwards in a young child, the first and most important thing to rule out is a tumor in the eye or brain, or another neurologic condition.”
WARNING: It is impossible to rule out a brain tumor without an imaging study!
“The most common eye tumor in a child is retinoblastoma, and the child needs to have a dilated eye exam by an ophthalmologist ASAP,” says Dr. Kulkarni.
“He or she will be able to determine whether there is any concern for a tumor in the eye or brain and whether any additional testing is necessary.
“Luckily, most of the other causes of esotropia are benign. It can be congenital and tends to run in families.”
If you notice that one eye in your young child is suddenly turning inwards, and this condition indeed runs in your family, do not let this fact deter you from having tests to rule out a brain tumor.
Don’t just think, “It runs in the family; it’s nothing.” It could be a coincidence that it runs in the family.
“It could also simply represent a need for glasses,” adds Dr. Kulkarni. “It could also be due to the appearance of, but not truly misaligned eyes due to the shape of the eyelids and nasal bridge
“Any child suspected of having misalignment of the eyes should have a thorough examination by a pediatric ophthalmologist.”
Note: The first doctor to see for a child with one eye turning inward is the pediatric ophthalmologist, NOT the family optometrist!
Though the drifting inward of one eye is usually a benign situation in young children, you’ll want to rule out the worst case scenario first.