esophoria
Esophoria is a tendency of the eyes to deviate inward if fusion is blocked.1 Fusional divergence keeps the deviation latent, and an esodeviation that fusion controls only part of the time is called intermittent esotropia.2
A slight phoria is present in most normal people and is overcome by the fusion reflex. If fusion cannot control the imbalance, the esophoria is called decompensating and often causes asthenopia or diplopia. On the uncover test, the eye that was covered makes an outward (abducting) recovery movement as the cover comes off.1
Most esophoria is accommodative. Uncorrected hyperopia or prolonged close work drives excess accommodation, and the accommodation-convergence linkage converts the excess accommodation into excess convergence. Esophoria without this accommodative factor is called nonaccommodative or anatomical esophoria.3
More detail
The Duane-White classification sorts esophoria by fixation distance.3 Divergence weakness esophoria decompensates at distance and stays compensated at near.3 Convergence excess esophoria increases at near, with a small compensated phoria at distance and a larger decompensated esophoria at near.3 Basic esophoria is decompensated by about the same amount at distance and at near.3
Sources (5)
- Kanski, Clinical Ophthalmology (2024), ch. 18
- von Noorden and Campos, Binocular Vision and Ocular Motility, ch. 16
- Pickwell's Binocular Vision Anomalies, ch. 7
- Rutstein, R., Daum, K. (1997). Anomalies of Binocular Vision: Diagnosis & Management, Mosby.
- Scheiman, M., Wick, B. (2014). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders. 4th ed., Lippincott Williams & Wilkins.
Reviewed October 2026