Acute acquired comitant esotropia.

Abstract

SUMMARY Acute acquired comitant esotropia has been used to describe a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive error. We describe six children aged 5 to 11 years who developed an acute non-accommodative esotropia with diplopia. Neurological examination, including CT scan, in each of these children gave negative results. We suggest that this is an unusual presentation of esotropia of undetermined aetiology. The diagnosis, clinical characteristics, and management are discussed.Acute acquired comitant esotropia (AACE) is an unusual presentation of esotropia which occurs in older children and adults. It is characterised by acute onset of esotropia with diplopia. The refractive error is insignificant and neurological examination gives normal results. The purpose of this paper is to discuss the diagnosis and management of this' unusual condition in children. Patients and methods

Long-term follow-up of children with acute acquired concomitant esotropia

“…These measurements show a strong concordance with previous reports. 3,7 Approximately one half of the children (52%) described diplopia. Double vision has previously been shown to be an inconsistent feature of this condition, partly because of the young age of some of the children.…”

“…1,2 Treatment options include prisms, botulinum toxin therapy, and, most commonly, strabismus surgery; however, the level of binocularity achieved by different patients varies markedly. [3][4][5][6][7][8] Most previous reports presented only small case series 3,8,9 or even single cases with AACE type 2. 5, 6 We set out to ascertain the clinical features and surgical outcome of AACE type 2 in a larger case series of children with specific attention to the longterm follow-up.…”

Acute Comitant Esotropia in a Boy with Head Trauma and Convulsions Receiving Carbamazepine

“…Acute comitant esotropia is though to develop following artificial interruption of fusion, such as patching one eye, or physical or psychic shock. The disorder is sometimes associated with myopia and neurological disease, including brain tumor [1][2][3][4][5][6]. Our patient had head trauma and convulsions, but no patching of one eye, physical or psychic shock, myopia, or brain tumor.…”

“…It is sometimes accompanied by diplopia, large angle esotropia, and no signs of paralysis [1][2][3][4][5][6]. Our patient was an 11-year-old boy who had diplopia and large angle esotropia.…”

“…Acute onset of esotropia with diplopia in older children is uncommon in relation to the high frequencies of infantile or congenital esotropia [1][2][3][4][5][6]. We recently experienced this uncommon condition and nystagmus in a boy with head trauma and convulsions who was receiving carbamazepine.…”