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My daughter can turn her eye inward at will -- should I worry?

Asked by Angela Wiser, Glenarm, Illinois

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My 3-year-old daughter has a trick. She can turn her right eye completely inward at will. We noticed it when she was an infant and have taken her several times to a pediatric ophthalmologist. He checked her out, dilated her pupils and suggested that there was nothing wrong, especially now that she has control over it. Should I stop worrying about it now, or go get a second opinion (the second opinion would be quite a drive)?

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Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thank you for your question. Involuntary (uncontrollable) inward movement of the eyes in the first few months of life can be normal, and it typically disappears once a baby's eye muscles strengthen and become better coordinated. Being able to turn one's eye inward at will as a child gets older can also be normal, as your pediatric ophthalmologist has suggested. Over time your daughter may stop trying to turn her eye inward and you will not need to worry. In addition, if she has some movement of her eye that is happening beyond her control, it will be necessary to undergo further evaluation. Sometimes it can be hard to tell if the eye turning is being done at will in children this age, and there may also be different findings on repeat testing, so it's important to have close continued follow-up with a pediatric ophthalmologist.

I consulted with Dr. Ravi D. Goel, a board-certified ophthalmologist at Regional Eye Associates in Cherry Hill, New Jersey, and an Instructor on the Wills Eye Institute Cataract and Primary Eye Care Service in Philadelphia, Pennsylvania. He reports that uncontrolled inward deviations of the eye may occur more often when a child is tired, so you may want to monitor whether this is happening more when your daughter is sleepy. Because this type of disorder can put a child at risk for permanent vision loss, a second opinion can be helpful. If the second physician agrees with the first, the parents' minds will be at ease. If there is a difference in the diagnosis, the patient will benefit from a rigorous evaluation and treatment if needed.

Your daughter's pediatrician can also check out her "trick" and help you decide whether a drive for a second opinion would be warranted. Good luck!

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