Acute Acquired Comitant Esotropia in Adults: Is It Neurologic or Not?

Abstract EN

Objectives.

Acute acquired comitant esotropia (AACE) can be a diagnostic challenge for ophthalmologists and neurologists because of its association with neurological pathologies.

Our study describes a series of adult patients with AACE of undetermined etiology.

Methods.

Data on the clinical findings of patients presented with AACE of undetermined etiology with a minimum follow-up of 1 year were retrieved from the medical records and the results analyzed.

Results.

A series of 9 esotropia cases (age range: 20–43 years) was reviewed.

All patients had full duction and versions, without an A-pattern or V-pattern.

All patients had esotropia for distance and near.

Neurological evaluation in all cases was normal.

Among patients, 3 were treated with prisms, 4 were treated with strabismus surgery, and 1 was treated with botulinum toxin injections; 1 patient declined treatment.

In treated patients posttreatment sensory testing indicated restoration of binocularity that remained stable throughout follow-up of 1–9 years.

The patient that declined treatment had binocular function with base-out prisms.

Conclusion.

Acute onset esotropia may be seen without a neurological pathology in adults.

Good motor and sensory outcomes can be achieved in these patients with AACE of undetermined etiology via surgical and nonsurgical methods.