“Wall eye” is a common term for exotropia, a condition where one or both eyes turn outward, away from the nose. This eye misalignment, a type of strabismus, can impact vision and may occur at any age. Understanding exotropia involves recognizing its appearance, exploring its underlying causes, identifying its signs, and learning about available management options.
What Wall Eye Means
Wall eye, or exotropia, describes a form of strabismus where an eye deviates outward. One or both eyes turn towards the ear. This outward turning can affect a single eye (monocular) or alternate between both eyes (alternating), and it can be present all the time (constant) or only sometimes (intermittent).
The appearance of exotropia varies; sometimes the deviation is subtle, while other times it is quite noticeable. Intermittent exotropia is the most common type, where the eye turns outward only under certain conditions, such as when a person is tired, sick, or looking into the distance. Constant exotropia, where the eye consistently turns outward, is less common.
How Wall Eye Develops
Exotropia arises from an imbalance in the muscles that control eye movement, or issues with the nerves that coordinate them. Proper eye alignment relies on these muscles and nerves working in unison to direct both eyes towards the same point. When this coordination is disrupted, one eye may drift outward.
Causes of Exotropia
Several factors can contribute to the development of exotropia. Genetics play a role, as strabismus can run in families. Neurological conditions such as cerebral palsy, Down syndrome, or brain tumors can also lead to exotropia.
Contributing Factors
Uncorrected refractive errors can contribute to its development. Additionally, physical trauma to the head or face, including orbital fractures, can damage eye muscles or nerves and result in exotropia. Exotropia often develops in early childhood, but it can also occur in adults.
Recognizing Wall Eye
The most evident sign of wall eye is the outward turning of one or both eyes. This deviation may be more apparent when an individual is fatigued, unwell, or focusing on distant objects. Parents might notice their child squinting or closing one eye, especially in bright sunlight, as a way to manage the visual discomfort.
Beyond the visible misalignment, exotropia can cause other symptoms. Individuals might experience double vision, where they see two images of a single object. Eye strain, headaches, and difficulty with depth perception are also common complaints. A comprehensive eye examination by an optometrist or ophthalmologist is necessary for a proper diagnosis. During this examination, tests like the cover-uncover test are performed to identify and measure any misalignment.
Addressing Wall Eye
Managing exotropia depends on factors such as its cause, severity, and the individual’s age. Corrective eyeglasses or contact lenses can be prescribed, especially if uncorrected refractive errors contribute to the condition. These lenses help the eyes focus properly, which can sometimes improve alignment.
Patching therapy, where the stronger eye is covered, may be used to encourage the weaker eye to strengthen and improve its vision. Vision therapy, which involves specific eye exercises, can help improve eye muscle coordination and control, particularly for conditions like convergence insufficiency. In some cases, surgical correction is performed to realign the eye muscles. This procedure aims to adjust the tension of the muscles that control eye movement, allowing the eyes to work together more effectively. Early intervention, especially in children, is important to prevent complications such as amblyopia, commonly known as lazy eye, which can lead to permanent reduced vision in the affected eye.