How does a child develop crossed eyes?

Childhood esotropia, commonly known as "crossed eyes," is typically caused by the following factors: 1. Genetic factors: Esotropia has a familial hereditary tendency. If parents or close relatives have a history of esotropia, the child's likelihood of developing the condition is relatively higher. 2. Congenital developmental abnormalities: Abnormal development of the position of the extraocular muscles, poor muscle separation, anomalies in muscle sheaths, or paralysis of the nerves controlling the eye muscles may all contribute to the development of esotropia. 3. Eye diseases: Conditions such as trichiasis, entropion, dacryocystitis, and conjunctivitis may also lead to the appearance of crossed eyes in children. 4. Refractive errors: This is commonly seen in children with hyperopia (farsightedness). Due to blurred vision, the eyes exert excessive accommodative effort, resulting in over-convergence and subsequently triggering esotropia.