Consecutive cyclic exotropia after surgery for adult-onset cyclic esotropia

Acquired cyclic exotropia and hypotropia

“…An afferent defect caused by intraocular structural damage leading to secondary changes in the central nervous system may be proposed as the mechanism in our patient with severe visual impairment in one eye. In contrast to the patient described by Garg and Archer, 1 where the patient developed consecutive cyclic exotropia after surgery for cyclic esotropia, the cycles disappeared completely after our patient was managed by conventional recession-resection surgery on the horizontal rectus muscles. …”

“…[5][6][7][8][9][10] Most cases occur in children and are idiopathic. 1 In adults, cyclic deviations usually occur after decreased vision in one eye and are associated with suppression and poor binocular vision. 1 Cole and colleagues 6 postulated that the trigger zone for cyclic esotropia may lie in the oculomotor nuclei or their interconnections or perhaps within the sensory pathways that effectively control the oculomotor nuclei.…”

“…1 In adults, cyclic deviations usually occur after decreased vision in one eye and are associated with suppression and poor binocular vision. 1 Cole and colleagues 6 postulated that the trigger zone for cyclic esotropia may lie in the oculomotor nuclei or their interconnections or perhaps within the sensory pathways that effectively control the oculomotor nuclei. Troost and colleagues 5 reported a case of cyclic esotropia and hypertropia after retinal detachment which they attributed to periodic sympathetic hyperactivity or cyclic oculomotor nerve dysfunction.…”

“…5 Cyclic vertical deviations and cyclic exotropia appear to be very rare. [1][2][3][4] Cyclic vertical deviation has been described by Metz and colleagues 4 in a patient after craniofacial surgery. Clarke and Scott 11 described cyclic third nerve palsy.…”

The best of the best: a review of select pediatric ophthalmology and strabismus case reports published in 2015

“…15 Botulinum toxin injection has shown varied success. 16,17 The authors propose that their method of prismatic correction of the latent deviation breaks the esotropic cycle by relieving the compensatory effort to maintain an esophoria, indicating that cyclic strabismus is due to a progressive loss of compensation.…”