Getting Kids Out of Bifocals, Understanding Esotropia in Children: How Vision Therapy Can Help

If your child is struggling with crossed eyes, double vision, or reading difficulties, esotropia may be the underlying cause. Fortunately, vision therapy offers a proven, non-surgical path to lasting improvement.

Esotropia is a type of binocular vision dysfunction that affects many school-aged children, teenagers, college students, and even adults. It can interfere with learning, self-esteem, and social interaction—especially when it's not diagnosed early. If you're a parent in Newport Beach, San Juan Capistrano, Laguna Niguel, Coto de Caza, Ladera Ranch, Culver City, Palos Verdes, or West Los Angels, this guide will help you understand what esotropia is, how to spot it, and the best ways to treat it.

While bifocals are often prescribed to help with cosmetics and help prevent double vision, they do not treat the actual underlying cause of the esotropia which is incorrect guidance of the brain in coordinating the eyes together. Luckily, we now have better understanding of the neuro-physiology and treatments that help the brain calculate space better and get rid of the esotropia WITHOUT bifocals.

What Is Esotropia?

Esotropia is a condition where one or both eyes turn inward. It's a form of strabismus and can appear constantly or only under specific circumstances like fatigue, illness, or focusing on near tasks.

The inward eye turn can cause double vision, blurry vision, headaches, and difficulty with depth perception. In children, esotropia often develops due to a mismatch between the eyes' ability to focus (accommodation) and the muscles controlling eye alignment.

When a child’s focusing system works harder than it should—especially during reading or screen use—one eye may begin to turn inward to compensate. This is known as accommodative esotropia.

Common Signs and Symptoms of Esotropia

Recognizing the early signs of esotropia is key to helping your child avoid long-term vision issues and academic challenges. Look for the following:

• One eye turning inward, especially when reading or focusing on close objects

• Frequent complaints of double vision or closing one eye to see better

• Poor coordination or depth perception (frequent tripping or bumping into things)

• Headaches or eye strain after screen time or homework

• Difficulty reading or losing place on the page

• Squinting, eye rubbing, or tilting the head

• Avoidance of near tasks like reading or coloring

Children rarely report their symptoms clearly, so these behaviors are often subtle and can be mistaken for laziness or attention issues.

Esotropia Treatment Options

Bifocals in Children

For many children with accommodative esotropia, bifocals are often the first line of treatment. These lenses reduce the focusing demand during near work, reducing the stimulation from the brain's spatial miscalculation and pull the eyes inward. However, bifocals do NOT actually treat or cure the cause of the brain's miscalculation that leads to the eye turning inward.

Modern bifocal designs for children are discreet and effective, but they are not a cure—they’re a tool. While they may reduce the eye turn, they do not address the underlying binocular vision dysfunction.

Surgery

Eye muscle surgery is sometimes recommended for severe cases. However, surgery only alters eye alignment—it doesn't retrain the brain to use both eyes together. As a result, many children who undergo surgery may experience regression or continued symptoms, especially if the binocular vision dysfunction is left untreated.

How Vision Therapy Helps Children with Esotropia

Vision therapy is a customized, doctor-supervised program that retrains the eyes and brain to work together. It addresses the root cause of esotropia—not just the symptoms.

Our clinic has seen tremendous success helping patients of all ages improve their visual alignment and eliminate double vision through therapy.

Using tools like:

• Stereograms and vectograms to enhance depth perception

• Vergence training to improve eye coordination

• Anti-suppression techniques to teach the brain to use both eyes equally

• Accommodative activities to improve the accuracy off the focusing system

We help our patients build the visual skills they need to read, learn, and thrive in school.

Unlike patching (which only treats one eye), vision therapy trains binocular vision, helping the eyes function as a team. This is especially critical in cases of intermittent esotropia, where suppression (the brain ignoring one eye) can develop.

Real Success Stories from Our Clinics

One 8-year-old patient from Laguna Niguel came to our clinic with daily headaches, reading struggles, and inward eye turn diagnosed as accommodative esotropia. Her pediatric eye doctor had prescribed bifocals, but her symptoms continued. After 6 months of targeted vision therapy, her headaches resolved, her eye alignment improved significantly, and she was reading confidently at grade level.

Another middle schooler from Culver City had been recommended for strabismus surgery. Instead, his family sought a second opinion. After a comprehensive evaluation, we found the issue was functional—not muscular. With therapy, his esotropia was resolved without surgery.

These are just two of many stories where our individualized, evidence-based approach has helped children avoid surgery and regain comfortable, clear vision.

The Importance of Early Intervention

Esotropia that develops in early childhood can lead to amblyopia (lazy eye) or long-term suppression if not properly treated. The earlier the condition is identified, the greater the chances of full recovery.

At our clinics in Newport Beach, Ladera Ranch, Bel Air, and surrounding areas, we offer comprehensive developmental vision exams that go beyond basic eye charts. Our doctors assess how your child’s eyes work together—not just how clearly they see.

If your child has been prescribed bifocals but still struggles, or if you’ve been told surgery is the only option, we encourage you to explore what vision therapy can do.

Take the First Step Toward Better Vision

If you're a parent in San Juan Capistrano, Newport Beach, Palos Verdes, West Los Angeles, Coto de Caza, or anywhere in Southern California, don’t wait for the problem to worsen.

Schedule a developmental vision exam today

Together, we can uncover the root cause of your esotropia and create a customized treatment plan for lasting results.

Learn more about our approach to Vision Therapy and why so many families trust us to help their children thrive—visually and academically.

Keywords Summary:

Primary Keyword: esotropiaSecondary Keywords: binocular vision dysfunction, bifocals in children, esotropia treatmentCities included: Newport Beach, San Juan Capistrano, Laguna Niguel, Coto de Caza, Ladera Ranch, Culver City, Bel AirCall to Action: Schedule a developmental vision exam todayInternal Links: Vision Therapy, Contact Us pages

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