Presentation
Indeed, patients with intermittent esotropia at presentation were nearly three times more likely to remain bifixators over time than patients presenting with constant esotropia. [healio.com]
Persistent esotropia that is present after 2 months of age is probably pathologic and usually does not resolve spontaneously. [wrighteyecare.com]
The doctors presented a cross-sectional, retrospective and observational study, focusing on their career in the ICR Ophthalmology Center from 2015 to 2020. [icrcat.com]
Cyclic esotropia should be considered in the differential diagnosis when an individual presents with a history of intermittent strabismus that is present some days and not others. [ncbi.nlm.nih.gov]
Entire Body System
- Surgical Procedure
This was the only surgical procedure for all patients included in this report. [ncbi.nlm.nih.gov]
- Cerebral Palsy
Factors that can increase the risk of developing esotropia include: Brain disorders such as cerebral palsy, hydrocephalus, and brain tumors Family history of any type of strabismus, amblyopia (“lazy eye”), childhood cataract, or glaucoma Genetic disorders [utswmed.org]
No known cause (idiopathic); possibly familial Down syndrome Cerebral palsy Hydrocephalus (Increased intra-cranial pressure) Brain tumors Trauma Both esotropia and exotropia may be congenital (present at birth) or acquired (developed later, during childhood [childrensnational.org]
palsy, Laurence-Moon-Biedl syndrome, pseudohyperparathyroidism. esotropia Convergent strabismus Ophthalmology Strabismus characterized by a convergence of the visual axes. [medical-dictionary.thefreedictionary.com]
At 8 months old he was diagnosed with cerebral palsy… Read More Alexandra (Aly) age 19 months Aly’s journey to glasses started a little differently than most babies. [eyepowerkidswear.com]
- Fatigue
An example of intermittent esotropia would be if it was only seen during reading or fatigue. [kanataoptometry.ca]
Magnetic resonance imaging, electromyography, electroencephalography, and ocular and orbital echography were unremarkable, as was a neurological assessment that included fatigue and edrophonium testing. [ncbi.nlm.nih.gov]
If the eyes aren't aligned, it can lead to other problems, including: Blurry vision that affects daily activities Eye fatigue and strain Headaches Double vision Poor 3-D vision [webmd.com]
- Pallor
Eyelid retraction Fourth cranial nerve palsy Duane anomaly Cranial nerve paralysis Rod-cone dystrophy Amblyopia Ptosis Hearing impairment Retinal dystrophy Optic disc pallor Abnormal retinal morphology EEG with spike-wave complexes (>3.5 Hz) Abnormality [mendelian.co]
One patient with AACE, who was referred for surgery, had significant distance–near disparity in the measured esodeviation and suspicious temporal pallor. [kjophthal.com]
- Trisomy 21
This finding appears to be associated with trisomy 21. Horizontal extraocular muscle surgery may improve the head tilt in such patients. [ncbi.nlm.nih.gov]
Gastrointestinal
- Nausea
[…] during or after reading fatigues quickly during reading twists or tilts head toward book or object so as to favor one eye frequently loses place or skips lines while reading uses finger to read Your child frequently complains of : headaches or eyestrain nausea [vision3d.com]
Systemic : Browaches, nausea, abdominal cramps. Prolongs action of succinyl choline, thus latter anaesthetic not to be used if child was on miotics with in 6 weeks prior to surgery. [eophtha.com]
When it is important not only if music in viagra ad other cake birthday viagra focal deficits lengthy loss of vision, and occasionally, nausea and vomiting (often posttussive). [smj.org.sa]
Potential Harms Esotropia Short-term side effects of cycloplegic and dilating agents may include hypersensitivity reactions, fever, dry mouth, rapid pulse, nausea, vomiting, flushing, and, rarely, behavioral changes. [guidelinecentral.com]
Eyes
- Esotropia
Patients with intermittent esotropia were usually straight until a detailed accommodative target was utilized to produce esotropia. Every attempt was made to record the duration of intermittent and of constant esotropia. [healio.com]
It is defined as a large esotropia with onset prior to six months of age. The esotropia may present at birth although, in many cases, the esotropia is acquired during the first six months of life. [wrighteyecare.com]
Congenital Esotropia Congenital esotropia, also known as infantile esotropia, develops within the first six months of life. Even though it is called congenital esotropia, this condition rarely presents at birth. [verywellhealth.com]
Conclusions: All children exhibited the typical features of acute acquired comitant esotropia (AACE) type II (Burian-Franceschetti). [zora.uzh.ch]
- Strabismus
Time and suddenness of strabismus onset may be less helpful in defining this entity. [zora.uzh.ch]
Causes Strabismus may run in the family. However, affected family members do not necessarily share the same type or severity of strabismus. A child with a family history of strabismus should be seen by a pediatric ophthalmologist. [verywellhealth.com]
[…] esotropia, or congenital esotropia as it is often termed, is the most common form of infantile strabismus. [wrighteyecare.com]
Final report of the early vs. late infantile strabismus surgery study (ELISSS), a controlled, prospective, multicenter study. Strabismus. 2005 Dec. 13(4):169-99. [Medline]. Zak TA, Morin JD. [emedicine.medscape.com]
Patients with strabismus were underwent an eye examination in cycloplegia to exclude high refractive errors often cause strabismus. Figure 7: is a representation of Hirschberg test. [medcraveonline.com]
- Diplopia
Accompanying features such as diplopia, covering one eye or stumbling were observed in 40 % of the children. [zora.uzh.ch]
diplopia in this setting. [ncbi.nlm.nih.gov]
- Blurred Vision
CASE REPORT: A 23-year-old male patient reported to the clinic with sudden onset of blurred vision, inward deviation of the eyes, and binocular diplopia. On examination, he was diagnosed to have acute onset esotropia resulting from SNR. [ncbi.nlm.nih.gov]
If blurred vision continues to be an issue, your eye specialist may prescribe atropine eye drops for a few days to relax the child’s natural focusing muscles. This may help clear the child’s vision. [texaschildrens.org]
[…] loss or blurred vision Loss of color vision Pain often occurring before the visual symptoms Pain with eye movement Labs, Studies and Physical Exam Findings Visual acuity test Color vision test MRI of the brain Treatment Treat the underlying cause Current [physicianassistantexamreview.com]
Vision disorders that are not totally cured through vision therapy may still be ameliorated with significant improvement in visual function and quality of life. [focusvisiontherapycenter.com]
Symptoms of esotropia Symptoms of esotropia include: Blurred vision. Double vision. One or both eyes pointing inwards (misalignment of the eyes). Reduced vision. Tilting the head to the side. A child rubbing their eyes. [medic8.com]
- Visual Impairment
Unlike cyclic esotropia in children, the few reported adult cases have often been associated with severe acquired monocular visual impairment; however, the response to surgical treatment is reported to be the same as that in children. [ncbi.nlm.nih.gov]
No correlation existed between the degree of visual impairment and the direction of deviation. This fact emphasizes the importance of performing a fundus examination in each patient presenting with strabismus. Race No racial predilection exists. [emedicine.medscape.com]
[…] of visual evoked potentials Limb hypertonia Corpus callosum atrophy Short upper lip Prominent fingertip pads Laryngotracheomalacia Hearing impairment Sensorineural hearing impairment Cognitive impairment Syndactyly Visual loss Headache Facial palsy Hypermetropia [mendelian.co]
Treatment may include correction of visual impairment with patching and corrective lenses, alignment by corrective lenses, and surgical repair. Strabismus occurs in about 3% of children. [merckmanuals.com]
Neurologic
- Confusion
2 cases revealed a tumor in the cerebellopontine angle and 1 case involved spinocerebellar ataxia as revealed by genetic testing.AACE in this study was characterized by a sudden onset of concomitant nonaccommodative esotropia with diplopia or visual confusion [ncbi.nlm.nih.gov]
There is no intent to confuse, but rather to make things more clear. Parents cannot always tell which eye is turning and which isn’t, especially when the condition alternates or the misalignment is very small. [kanataoptometry.ca]
There is no intent to confuse, but rather to make things more clear. Parents cannot always tell which eye is turning and which isn't, especially when the condition alternates or the misalignment is very small. [eyeconx.net]
Alternating esotropia can be quite confusing to parents trying to figure out which eye is the straight eye. Strabismus may be caused by the unequal pulling of muscles on one side of the eye or paralysis of the ocular muscles. [waterdownoptometric.ca]
Workup
A head CT and facial bone workup revealed a subacute subdural hemorrhage in the right frontal lobe. [pediatrics.aappublications.org]
PREOPERATIVE EVALUATION In these patients with progressive esotropia with high myopia (greater than −9.00 diopters but generally greater than −15.00 diopters), further workup is generally necessary. [journals.lww.com]
Acute ET can be caused by intracranial pathology, so a full workup is necessary to definitively rule-out such causes. A thorough history regarding duration, neurological symptoms, and ocular history should be obtained. [webeye.ophth.uiowa.edu]
We evaluated patient history, clinical presentation, workup, treatment and outcomes. Between one and three pre-surgical examinations were carried out, in order to establish angle stability. [bmcophthalmol.biomedcentral.com]
Treatment
Treatment for Esotropia Early detection and treatment: as with most medical conditions, and particularly in children, early detection of the esotropia with prompt, effective treatment is a significant predictor of successful outcome. [pediatricophthalmologypa.com]
Treatment Treatment will depend on the severity of the esotropia. Most babies outgrow intermittent strabismus by the age of 3 months, and there is no need for treatment. [verywellhealth.com]
In this case, more treatment will be necessary. The goal of treatment for amblyopia is to strengthen the eye with decreased vision and allow it to partner with its fellow eye more easily. [kanataoptometry.ca]
Prognosis
The diagnosis, clinical features, etiology, treatment, prognosis, and clinical course for the 3 types of accommodative esotropia are presented. [ncbi.nlm.nih.gov]
Prognosis Binocular sensory function is usually severely compromised by even brief periods of abnormal binocular experience during the first year of life. [emedicine.medscape.com]
Treatment after age two decreases the prognosis for re-establishment of binocular vision. The chances of developing it with surgery alone diminish with age. [waterdownoptometric.ca]
Key Points Onset within the first six months of life Infant uses either eye Usually associated with large-angle strabismus Best treated with early surgery Amblyopia in 50% of patients Poor prognosis for high-grade stereo acuity (depth perception) Infantile [wrighteyecare.com]
It is important to emphasize realistic expectations concerning the prognosis. [eyesoneyecare.com]
Etiology
Many etiologies are described in the literature to cause an esodeviation that is greater at distance than near in adult patients and some exist in conjunction with a neurological condition. [ncbi.nlm.nih.gov]
These etiologies are benign or have functional causes. [dovepress.com]
Epidemiology
Amblyopia (reduced visual acuity due to an abnormal visual experience early in life) frequently develops if the condition remains untreated. [1] Epidemiology Race No racial predilection exists for esotropia with high AC/A ratio. [emedicine.medscape.com]
Researchers investigated the prevalence of psychiatric disorders among young adults who had CET as children using data from the Rochester Epidemiology Project. [mayoclinic.org]
Pathophysiology
Recent studies have shown that loop myopexy with or without medial rectus recession can be performed without sclera fixation sutures to correct the underlying pathophysiology. [ncbi.nlm.nih.gov]
Pathophysiology Additional laboratory and clinical research often is required to determine the etiology of the acquired strabismus. [emedicine.medscape.com]
Although many theories can be confounding, Krzizok et al.[8] went further into describing the pathophysiology. [journals.lww.com]
Considerations on pathophysiology and aetiology. In Transactions of the Fifth International Orthoptic Congress. 119–25. (eds Ravault, A.P. & Lenk, M.). LIPS, Lyon. Google Scholar Jay, W.M. & Hoyt, C.S. (1980). [link.springer.com]
Prevention
Early intervention can: rule out any potentially serious underlying disease identify appropriate treatment to quickly correct the crossed eye and prevent lingering long-term effects. [notes.childrenshospital.org]
Children with successfully treated accommodative esotropia need to be followed up with to prevent possible deterioration and development of a superimposed nonaccommodative esotropia, which in some cases may require extraocular muscle surgery. [ncbi.nlm.nih.gov]
The pathway illustrated in black is the only pathway leading to active prevention of strabismus that is a systematic path without an opportunistic referral. [doi.org]