squint

what corrected pd number would be good. what i mean is that the turn (inward) wont be noiceable to normal people.

[John C Hagan III, MD, FACS, FAAO]

most people will not notice 10-15 diopters or less of esotrophia.

JCH MD

[sarah43]

Thanks, what about exo dp?and would you do surgery on it either exo/eso if 10-15dp.

[John C Hagan III, MD, FACS, FAAO]

Generally XT is more noticable than ET so perhaps 10 or less

It's really too complicated to make simple: It depends on patients age, health, how well they fuse, how willing to accept risk of surgery, etc.

JCH MD

[sarah43]

last question on this- when surgery is done on inturning eye (both eyes operated on)and is 10dp undercoreected intentianally to allow room if becomes exot,.what are the chances of it becomeing noticably exo? how far(dp) will it become exo?

[John C Hagan III, MD, FACS, FAAO]

It depends on whether fusion develops. If fusion present one does not aim to under-correct the surgery is done to leave the eyes perfectly straight.

If fusion is not present that undercorrection 10D is reasonable because as we age the background tone that the eyes have is outward so many eyes do drift outward as a person ages.

If the eye drifts out there is no way to determine how far out it will goe.

JHC  MD

[sarah43]

the surgery was done to undercorrect becaose i have never used eyes together (no \fusion), large eso(35/dp think), vision s good in both eyes now corrected at 10dp and have slight double vision not causing great problem but do you think this is because eyes are closer together and trying to fuse. andl ike you said that eyes tend to drift out as we age and if they do, wll my double visin get worse and may they fuse when it drifts to straight ?
what do you mean by background tone?
thanks in advance and have a great chrismas ;-)

[John C Hagan III, MD, FACS, FAAO]

Having straight eyes doens't mean they will fuse.  Congential esotrophia patients born with crossed eyes never develop perfect fusion even if surgery makes their eyes straight.

Background tone means that if an eye goes blind in a child it will always drift in towards the nose, if the same thing happens in a 60 year old it drifts out that is "tone".

It changes slowly over life from "in" to "out" but huge overlap at which age it happens.

JCH MD

Merry Christmas to you too.

[sarah43]

So if i hadnt had surgery would my eso eventually have become exo?

[John C Hagan III, MD, FACS, FAAO]

No one can tell for sure

JCH MD