Do you sometimes get eye strain, pain, or headaches after reading a book, working on the computer, or just sitting still? Do you sometimes feel like you're seeing two things at once? You may not know the cause, but it could be a very small difference in the alignment of your eyes. Today we're going to talk about one such condition, Exophoria.
Simply put, what is Exophoria?
Exophoria is when you close one eye with your hand and the closed eye moves outward, away from the nose. This is a slight change in the alignment, or alignment, of the eyes.
Think about it, normally both our eyes work together to show us the same image. But when one eye is closed, that eye can't focus on the same spot as the other eye. This causes the eye to deviate slightly to one side. In fact, it's normal to have a small deviation (phoria) like this. We all have this condition to some extent.
However, exophoria becomes a problem when this misalignment becomes too large. It becomes difficult for our eyes and brain to control it. This can interfere with our vision.
Why is eye alignment so important?
Our vision depends entirely on our eyes being perfectly aligned. When our eyes are perfectly aligned, our brain can "fuse" the images from both eyes, or combine them together, to create a clear three-dimensional (3D) view of the world. This is called binocular vision (stereopsis) .
A person with a more severe case of exophoria has difficulty integrating these two images into their brain, which is when other troubling symptoms emerge.
- Double vision or Diplopia: Seeing two things at once.
- Eye pain and strain: Eyes can hurt even after reading for a while or looking at the computer.
- Headaches: Frequent headaches, especially when doing work that requires the use of the eyes.
- Dizziness or vertigo: Sometimes you may feel like you are spinning.
What are the causes of exophoria?
As we mentioned earlier, when you use both eyes, your brain aligns and focuses on what you see with both eyes. Closing one eye can cause a slight twitching because that balance is lost. However, there are several other factors that can contribute to the severity of exophoria.
| Reason | Description |
|---|---|
| Anatomy | This can be something that is present at birth. Sometimes it can also develop during childhood. It can also be caused by weakness in the muscles that move the eyes. |
| Eyesight | People who are short-sighted, that is, those with myopia, are more likely to develop exophoria. |
| How to use your eyes | This condition can occur in people who regularly use only one eye for work or hobbies (e.g., those who use a microscope, binoculars, or a pair of gem-viewing glasses). |
| Other medical conditions | Exophoria can occur with head injuries, especially concussions and traumatic brain injuries (TBIs) . It can also rarely occur with conditions such as stroke. |
What are the treatments for this?
Most of the time, exophoria does not require treatment unless it causes other symptoms. However, if the condition becomes severe, it can develop into exotropia , a condition in which the eye turns outward without closing the eye.
There are several main treatment methods:
Glasses
Sometimes, exophoria can be controlled by using glasses or contact lenses that are adjusted to your vision impairment.
Vision Therapy
This is like physical therapy. Just like doing exercises to strengthen the muscles in your arms and legs, this involves doing special exercises to strengthen the muscles in your eyes. This helps keep your eyes aligned.
Prism Lenses
These are a special type of lens. They can be attached to eyeglasses or can be worn separately. These lenses change the way light enters the eye. This reduces the effort your eyes have to make to align themselves.
Botox® injections
OnabotulinumtoxinA, or the Botox® vaccine we all know, blocks nerve signals to muscles, weakening them. When injected into the muscles that pull the eye outward, the muscles weaken slightly, controlling the twitching of the eye.
Surgery
Surgery is considered only if all other treatments fail. This involves permanently weakening the muscles that pull the eye outward. This is a last resort because it is irreversible. You should discuss this with your doctor .
What are the risks if left untreated?
Exophoria is usually not a serious problem. However, if it is severe enough, it can get worse over time. This is called "decompensated exotropia."
The best example to understand this is the trolley in the supermarket. Imagine, if the two wheels of that trolley are not in line, how difficult it is to push it straight? We have to work harder to control it. Similarly, when the alignment of the eyes is lost due to Exophoria, our eye muscles and brain have to constantly work extra hard to correct it. This is why we get things like eye strain and headaches.
Over time, this condition can become severe and lead to exotropia , where the eye turns outward without closing the eye. This can be very disruptive to daily life.
Therefore, if you have frequent headaches, eye strain, or double vision, don't just ignore it. It's best to see an ophthalmologist for a checkup.
Difference between Exophoria, Esophoria and Exotropia
These three names are a bit similar, so it can be confusing. Let's see what the difference is.
- Exophoria: When one eye is closed, that eye moves outward (away from the nose) .
- Esophoria: When one eye is closed, that eye is pulled inward (towards the nose) .
- Exotropia: One eye is constantly turned outward , without closing the eye. This can occur when exophoria is severe.
How easy is it when everything in life is aligned? The same is true for our vision. If your eyes are not aligned properly, the symptoms that arise can interfere with your daily activities. So never be shy about asking your doctor about such symptoms. Even a small misalignment of a few millimeters can cause you great discomfort. A skilled doctor can accurately diagnose this condition and provide the most suitable treatment for you.
Take-Home Message
- Exophoria is a slight change in the alignment of the eyes, where when one eye is closed, that eye is pulled outward.
- Although many people have this condition, it only causes symptoms if the difference in alignment increases.
- If you are experiencing symptoms such as frequent headaches, eye strain, and double vision, it may be due to Exophoria.
- Do not try to diagnose or treat this yourself. Definitely see an eye specialist.
- There are effective treatments for this, such as eyeglasses, vision therapy, special lenses (prism lenses), and surgery.
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