Do esotropes typically develop nasal or temporal eccentric fixation?

• A. Nasal
• B. Temporal
• C. Both
• D. Neither

Answer: (A)

When the brain suppresses the fovea of a misaligned eye, it often uses a peripheral retinal area as the fixation point. In esotropia, where the eye turns inward toward the nose, the fixation point most commonly shifts to a region on the nasal retina of the deviated eye. Using this nasal retinal area as the fixation point helps align the deviated eye with the fellow eye and supports fusion despite the inward turn. That’s why nasal eccentric fixation is the typical pattern in esotropia. Temporal eccentric fixation is more associated with exotropia (outward deviation), not esotropia.