Hello doctor, I have had binocular, horizontal esotropia for two years now, worse on distant gaze. My ophthalmologist diagnosed it to be decompensated heterophoria. Is there anything I can do about it? I spend a lot of time writing and reading on my computer, could that make it worse?
Hi. Decompensated heterophoria, can result from a variety of decompensating factors. The most notable few are: Refractive errors are easy to detect and correct. You can do a simple test called pinhole test at home to check if you do have a refractive error. Just take any piece of paper and poke a hole in it with a pen. Then try looking at things at least 6 meters away. If you feel things look sharper or better in any way that means that you need glasses, or if you already wear glasses, then the power has changed. The sure shot way to diagnose refractive errors of-course is to get a cycloplegic refraction done by an ophthalmologist. Cases who do not respond may need an orthoptic referral for prismatic lenses.  Now coming to your question on writing or reading, there are numerous reports that say near work (reading and writing) are tasks that cause progression of myopia. If there has been any change in your working hours or intensity, this can also cause a decompensation. I suggest that you follow the 20-20-20 rule of taking a 20-second break every 20 minutes and looking 20 feet away while working on the computer, also take study breaks while reading or writing. Glasses with anti-reflective coating and lubricants may also help you work for longer periods with minimum strain on your eyes. With glasses of appropriate power and avoiding overexertion whilst reading or writing, your weakened fusional reflexes should make up some ground. Surgical treatments are considered only for cases not responding to the above measures. In case the problem persists or if you start to have problems like double vision, headache or increasing severity of symptoms, please consult your ophthalmologist. Partially accommodative esotropia with decompensation. Cycloplegic refraction. For more information consult an eye care ophthalmologist online.--->