My friend's eyes seem to operate independently of each other, not "cross eyed". Can this be fixed?

Question

After 30 years, I ran into an old high school boyfriend. Our children are now older than we were when we dated! Yet it's shocking how little has changed about us. That said, I was disturbed by my friend's eyes. They seem to, as I said above, operate independently. Sometimes both eyes are looking right at me. At other times, I had to decide which eye was focusing on me while the other one looked at different things, apparently. He apologised for not being able to "focus on things for long" and I said I hadn't noticed. I Googled this and all I could find was Strabismus (being cross-eyed or wall-eyed). This is definitely not that. Can it be fixed?

Thanks for the long answer, however it deals mostly with children, as if this is a problem with strengthening certain developing muscles. Please note I need answers for 50-year-old adults, whose muscles may be tired out. Thank you!

Answer 1

Exotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of esotropia. People with exotropia experience crossed diplopia. Intermittent exotropia is a fairly common condition. "Sensory exotropia" occurs in the presence of poor vision.

The brain's ability to see three-dimensional objects depends on proper alignment of the eyes. When both eyes are properly aligned and aimed at the same target, the visual portion of the brain fuses the forms into a single image. When one eye turns inward, outward, upward, or downward, two different pictures are sent to the brain. This causes loss of depth perception and binocular vision.

Contents
1 How does exotropia occur?
2 What are the signs of exotropia?
3 How is exotropia treated?
4 External links



How does exotropia occur?
The causes of exotropia are not fully understood. There are six muscles that control eye movement, four that move it up and down and two that move it side to side. All these muscles must be coordinated and working properly in order for the brain to see a single image. When one or more of these muscles doesn't work properly, some form of strabismus may occur. Strabismus is more common in children with disorders that affect the brain such as cerebral palsy, Down syndrome, hydrocephalus, and brain tumors.

What are the signs of exotropia?
The earliest sign of exotropia is usually a noticeable outward deviation of the eye. This sign may at first be intermittent, occurring when a child is daydreaming, not feeling well, or tired. The deviation may also be more noticeable when the child looks at something in the distance. Squinting or frequent rubbing of the eyes is also common with exotropia. Your child probably will not mention seeing double, i.e., double vision. However, he or she may close one eye to compensate for the problem.

Generally, exotropia progresses in frequency and duration. As the disorder progresses, the eyes will start to turn out when looking at close objects as well as those in the distance. If left untreated, the eye may turn out continually, causing a loss of binocular vision.

In young children with any form of strabismus, the brain may learn to ignore the misaligned eye's image and see only the image from the best-seeing eye. This is called amblyopia, or lazy eye, and results in a loss of depth perception. In adults who develop strabismus, double vision sometimes occurs because the brain has already been trained to receive images from both eyes and cannot ignore the image from the turned eye.


How is exotropia treated?
A comprehensive eye examination including an ocular motility (eye movement) evaluation and an evaluation of the internal ocular structures will allow an eye doctor to accurately diagnose the exotropia. Although glasses and/or patching therapy, exercises, or prisms may reduce or help control the outward-turning eye in some children, surgery is often required.

There is a rare form of exotropia known as "convergence insufficiency" that responds well to therapy. This disorder is characterized by an inability of the eyes to work together when used for near viewing, such as reading. Instead of the eyes focusing together on the near object, one deviates outward.

Because of the risks of surgery, and because about 35% of people require at least one more surgery, many people try vision therapy first. This consists of visual exercises. It is generally not covered by health insurance companies.

Surgery is sometimes recommended if the exotropia is present for more than half of each day or if the frequency is increasing over time. Surgery is also indicated if a child has significant exotropia when reading or viewing near objects or if there is evidence that the eyes are losing their ability to work as a single unit (binocular vision). If none of these criteria are met, surgery may be postponed pending simple observation with or without some form of eyeglass and/or patching therapy. In very mild cases, there is a chance that the exotropia will diminish with time.

The surgical procedure for the correction of exotropia involves making a small incision in the tissue covering the eye in order to reach the eye muscles. The appropriate muscles are then repositioned in order to allow the eye to move properly. The procedure is usually done under general anesthesia. Recovery time is rapid, and most people are able to resume normal activities within a few days. Following surgery, corrective eyeglasses may be needed and, in many cases, further surgery is required later to keep the eyes straight.

When a child requires surgery, the procedure is usually performed before the child attains school age. This is easier for the child and gives the eyes a better chance to work together. As with all surgery, there are some risks. However, strabismus surgery is usually a safe and effective treatment.

ADDTL DETAILS:

EXotropia, Diplopia and convergence insufficiency could also be an adult onset . Thyroid Ophthalmopathy and adult onset Strabismus; and cataracts ( not found in children) could also play a part.and of course, there is the macular degneration common among older people. These are eye-focusing problems. Surgery is certainly mentioned as an alternative therapy aside from vision therapy. which involves Not only eye muscle strenghtening exercises.

Go to these below sites to view evidence:


WEB RESULTS
exotropia.htm
CLASSIFICATION OF COMITANT EXOTROPIA - fixation distance + convergence insufficiency ... age of onset + congenital + infantile + childhood + adult ...www.umsl.edu/~optrgarz/exotropia.htm - 7k - Cached - More from this site - Save
EyeRounds.org:INTERMITTENT EXOTROPIA: A Major Review
... late onset exotropia after 6-7 years of age may experience diplopia because the ... rectus muscle resection and convergence insufficiency type should be treated ...webeye.ophth.uiowa.edu/eyeforum/tutorials/intermittent-exotropia.htm - 66k - Cached - More from this site - Save
Esotropia and exotropia.
Convergence exercises for convergence insufficiency. Extraocular muscle surgery ... onset strabismus includes all features of the comprehensive pediatric or adult ...www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3544&nbr=2770 - 46k - Cached - More from this site - Save
Care of the Patient with Strabismus: Esotropia and Exotropia (Clinical ... (PDF)
Whereas adult-onset strabismus can result from a ... convergence insufficiency exotropia. 63. c. Early Detection and Prevention ...www.aoa.org/documents/CPG-12.pdf - 196k - View as html - More from this site - Save
eMedicine - Esotropia, Acquired : Article by Antonio Pascotto, MD
The mean age of onset of the deviation was found to be significantly lower in ... with exotropia of 10 D or more may report NRC with heteronymous diplopia, ARC ...www.emedicine.com/oph/topic327.htm - 82k - Cached - More from this site - Save
eMedicine - Thyroid Ophthalmopathy : Article by Edsel Ing, MD, FRCS(C)
... exposure keratopathy, troublesome diplopia, and compressive ... is a more common finding with TAO, convergence insufficiency has been described. ...www.emedicine.com/oph/topic237.htm - 113k - Cached - More from this site - Save
JEFF MANN'S EM GUIDEMAPS – DIPLOPLIA
... and refer patients with binocular diplopia emergently to a neurologist ... work => may induce a convergence insufficiency => eyes tends to wander outwards ...www.jeffmann.net/NeuroGuidemaps/diploplia.html - 61k - Cached - More from this site - Save
Sue Crowe COT The Cole Eye Institute Cleveland Clinic Foundation (PDF)
Adult. Diplopia. Onset. Better or worse in different gazes ... Exotropia. Outward deviation. Types. Congenital. Intermittent. Convergence insufficiency ...www.ohioeye.org/pdf/2005annualmtg/INT4_InsOuts.pdf - 2545k - View as html - More from this site - Save
Child Health Resources | Children's Hospital & Regional Medical Center
... and symptoms of this condition are exactly the same as convergence insufficiency. ... Denver, specializing in pediatric ophthalmology and adult strabismus. ...www.pediatricweb.com/seattle/article.asp?ArticleID=812&ArticleType=9 - 33k - Cached - More from this site - Save
www.bashour.com/examprep/documents/Ocular Motility.FLS
... BSV^(iv) diplopia if sudden onset of exotropia ^(b) postoperative:^(i) diplopia ... (ii) treat any convergence insufficiency^(iii) often resolves ...www.bashour.com/examprep/documents/Ocular Motility.FLS - 65k - Cached - More from this site -


There are oodles of glossary terms for all eye disorders. i find this one to be appropriate:

Glossary of Terms
... binocularity (eye teaming) disorder, or by extended, intense use of the eyes. ... clinically shown to improve certain eye disorders, which are described above. ...
Saved by 11 people
www.vision-therapy.com/Glossary_of_Terms.htm -

I came across a lot of YA users with inability to google or find appropo info. You can research anything via the internet. You just have to know certain key words to search on. My medical background (critical care nurse for many, many years) and my constant thirst for new knowledge enable me to do this. That's why my reply reflects this intense and exhaustive research. I find www.dogpile.com also beneficial. It represents; encompasses or has comprehensive compilation of search engines not only google.

Answer 2

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Answer 3

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Answer 4

Too late I am afraid. These patients usually have micro squints that are not picked up on routine testing when they are young. If they are they can be helped with either patching or squint correction ops.

With severe squints left untreated the brain usually blocks out the vision from one eye which becomes effectively blind. With smaller levels of squint the brain may allow both eyes to function independently.

This does not allow binocular vision and leads to poor or absent depth perception. It cannot generally be corrected.

Answer 5

Thyroid disease is one of the most common health problems we face today. From a practical standpoint, there are many ways to approach this issue. Learn here https://tr.im/89T0p

Hypothyroidism, or underactive thyroid, is a very common problem, and there are many reasons for this, including drinking chlorinated and fluoridated water, and eating brominated flour.

Chlorine, fluoride, and bromine are all in the same family as iodine, and can displace iodine in your thyroid gland.

Secondly, many people simply aren't getting enough iodine in their diet to begin with. The amount you get from iodized salt is just barely enough to prevent you from getting a goiter.

Answer 6

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Answer 7

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Answer 8

He probably has a detached retina in one or both eyes. And yes, it can be easily fixed (medically, it is easy; financially, it is not that easy).