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Esotropia

Convergent Strabismus


Presentation

  • 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]
Asymptomatic
  • He has been asymptomatic after recession of a single medial rectus muscle.[ncbi.nlm.nih.gov]
Enuresis
  • A 5-year-old girl with previously unrecognized hyperopia of approximately 3.00 D developed esotropia while being treated with oxybutynin for enuresis. The esotropia disappeared with cessation of oxybutynin and correction of her hyperopia.[ncbi.nlm.nih.gov]
Esotropia
  • Accommodative esotropia is the most common pediatric strabismus and must be differentiated from other pediatric esotropias.[ncbi.nlm.nih.gov]
Ataxia
  • Of the 47 cases, brain and orbital imaging in 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[ncbi.nlm.nih.gov]
  • FIBROSIS OF EXTRAOCULAR MUSCLES, CONGENITAL, 1; CFEOM1 Is also known as ophthalmoplegia, congenital, blepharoptosis with absent eye movements, feom1 locus;feom Related symptoms: Autosomal dominant inheritance Intellectual disability Ataxia Strabismus[mendelian.co]
Downbeat Nystagmus
  • Patients usually present with headache, lower cranial nerve palsies, downbeat nystagmus, ataxia, or dissociated anesthesia of the trunk and extremities.[ncbi.nlm.nih.gov]
Cerebellar Ataxia
  • […] syndactyly Overgrowth Tall stature Dental malocclusion Paralysis Nail dysplasia Acrania Cortical visual impairment Anal atresia Craniofacial hyperostosis Restrictive external ophthalmoplegia Depressivity Blepharophimosis Ophthalmoplegia Progressive cerebellar[mendelian.co]
Personality Change
  • Symptoms that may suggest a neurological cause include [11]: Headache Clumsiness Developmental regression Balance, appetite, or personality changes Persistent diplopia Signs that may suggest a neurologic cause include [11]: Abnormalities of cranial nerves[webeye.ophth.uiowa.edu]
Nocturnal Enuresis
  • Three months later, the patient developed a consecutive esotropia of 18 PD in primary position with diplopia in all gazes triggered by Amitriptyline treatment prescribed one month earlier for nocturnal enuresis.[ncbi.nlm.nih.gov]

Workup

  • A head CT and facial bone workup revealed a subacute subdural hemorrhage in the right frontal lobe.[pediatrics.aappublications.org]
  • 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

  • METHODS: We evaluated PAL as an initial treatment modality or after initiating treatment with bifocals at various ages. Thirty-two patients, who did not undergo eye muscle surgery, were included in this retrospective study.[ncbi.nlm.nih.gov]

Prognosis

  • The diagnosis, clinical features, etiology, treatment, prognosis, and clinical course for the 3 types of accommodative esotropia are presented.[ncbi.nlm.nih.gov]
  • 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]

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]

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]
Sex distribution
Age distribution

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]
  • Amblyopia is reduced visual acuity due to an abnormal visual experience early in life. [1] Pathophysiology A patient with uncorrected hyperopia must accommodate to clear a blurred retinal image.[emedicine.medscape.com]

Prevention

  • If an orbital cyst affects the globe or extraocular muscles, it should be excised as soon as possible to prevent strabismus and amblyopia especially in infant.[ncbi.nlm.nih.gov]
  • What Can I Do To Prevent Esotropia From Developing? Esotropia cannot be prevented, but complications resulting from it can be prevented if the problem is detected early and treated properly.[eyehealthweb.com]

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