Esotropia vs Exotropia: Inward and Outward Eye Turns Explained
Quick answer: Esotropia is an eye that turns inward towards the nose; exotropia is an eye that turns outward. Both are forms of strabismus (squint), where the eyes do not point at the same place. In children they need early assessment because the turned eye can develop amblyopia (lazy eye). Treatment can include glasses, patching, prisms or eye-muscle surgery, depending on the type.
Noticed this in your own eyes? Book an eye examination (NPR 400) with an optometrist at Vision Concern Lazimpat, Boudha-Tushal or Makalbari. WhatsApp +977 9841466716.
Related service: Children's eye examinations at Vision Concern Lazimpat, Boudha-Tushal and Makalbari.
Types of eye turn
- Esotropia: inward turn (crossed eyes)
- Exotropia: outward turn (wall eye)
- Hypertropia / hypotropia: one eye higher or lower
- Constant or intermittent; one eye or alternating
Common causes
In children, esotropia is often linked to uncorrected long-sightedness (accommodative esotropia), and intermittent exotropia often shows when tired or looking far away. In adults, a new turn can come from a nerve palsy, thyroid eye disease, injury or a long-standing phoria that has broken down, and often causes double vision.
Treatment options
Accommodative esotropia is often fully corrected with glasses. Patching or atropine treats amblyopia. Prism glasses can help some adults with double vision. Eye-muscle surgery is done by an ophthalmologist for turns that glasses do not control. Vision Concern provides assessment, glasses and referral, not surgery.
When to get urgent care
A new eye turn in an adult with double vision, headache, droopy lid or weakness needs emergency care. A new turn in a child needs prompt assessment, and a white pupil reflex in photos needs urgent review.
How Vision Concern can help
Vision Concern optometrists in Kathmandu can examine your eyes, record what they find for comparison, update your glasses or contact lenses, and refer you to an ophthalmologist or eye hospital when medical treatment is needed. Vision Concern does not perform surgery or injections.
Frequently asked questions
Can esotropia be corrected with glasses?
Accommodative esotropia, caused by long-sightedness, is often corrected fully with the right glasses.
Is exotropia worse when tired?
Intermittent exotropia often shows more when tired, ill or daydreaming.
Do babies have crossed eyes?
Brief wandering in the first months is common, but a constant turn or one after 4 months needs assessment.
This guide is general information from the Vision Concern editorial team. It is not a diagnosis and does not replace an eye examination or medical advice.
Yes. Many visitors, particularly from Bangladesh and West Bengal (Kolkata), come to Nepal for cataract, retina, or other eye surgery at a hospital and also want new glasses, a general eye exam, or contact lenses at the same time, before or after their procedure. Vision Concern is an optical and eye-examination clinic, not a surgical hospital, so we work alongside hospitals such as Tilganga: we are happy to see you for glasses, contact lenses, or a routine check-up either side of your surgical treatment elsewhere.
No conversion is needed. Eyeglass prescriptions from Germany, France, the UK, the USA, China, Russia, and almost every other country use the same international format, SPH (sphere), CYL (cylinder), and AXIS, measured in diopters. Our opticians read this directly, so you can bring your prescription paper, a photo of it on your phone, or simply your current glasses, and we will use the same values. If your prescription is more than a year or two old, we recommend a quick, free re-check before we make your new pair.
Yes. Above roughly 3,000 metres, UV exposure increases sharply because of the thinner atmosphere and reflection off snow, and ordinary sunglasses (category 2-3) do not block enough UV to prevent snow blindness (photokeratitis). We recommend glacier glasses or category-4 sunglasses with side shields, and can fit these with your own prescription if needed. Vision Concern offers ZEISS polarized, UV400-certified sunglasses with prescription lenses, which we can prepare before you set off on your trek.