Neurological pathologies in acute acquired comitant esotropia

Abstract

Background Acute acquired comitant esotropia (AACE) is an uncommon subtype of esotropia characterized by sudden and usually late onset of a relatively large angle of comitant esotropia with diplopia in older children and adults. Methods A literature survey regarding neurological pathologies in AACE was conducted using databases (PubMed, MEDLINE, EMBASE, BioMed Central, the Cochrane Library, and Web of Science) in order to collect data for a narrative review of published reports and available literature. Results The results of the literature survey were analyzed to provide an overview of the current knowledge of neurological pathologies in AACE. The results revealed that AACE with unclear etiologies can occur in many cases in both children and adults. Functional etiological factors for AACE were found to be due to many reasons, such as functional accommodative spasm, the excessive near work use of mobile phones/smartphones, and other digital screens. In addition, AACE was found to be associated with neurological disorders, such as astrocytoma of the corpus callosum, medulloblastoma, tumors of the brain stem or cerebellum, Arnold-Chiari malformation, cerebellar astrocytoma, Chiari 1 malformation, idiopathic intracranial hypertension, pontine glioma, cerebellar ataxia, thalamic lesions, myasthenia gravis, certain types of seizures, and hydrocephalus. Conclusions Previously reported cases of AACE with unknown etiologies have been reported in both children and adults. However, AACE can be associated with neurological disorders that require neuroimaging probes. The author recommends that clinicians should perform comprehensive neurological assessments to rule out neurological pathologies in AACE, especially in the presence of nystagmus or abnormal ocular and neurological indications (e.g., headache, cerebellar imbalance, weakness, nystagmus, papilloedema, clumsiness, and poor motor coordination).

Acute acquired comitant esotropia induced by excessive digital device usage – literature review

“…Warto podkreślić, że AACE rozwija się również u pacjentów w starszym wieku. Wówczas może być związane z fizjologicznym zmniejszeniem amplitudy akomodacyjnej i występować z objawami zmęczenia oczu w przypadku długotrwałej pracy w bliży wzrokowej [12,25]. Krótkowzroczność jest najczęstszą wadą refrakcji wśród dzieci i młodych dorosłych [26].…”

Effect of the prism and Maddox rod test as the surgical target for type III acute acquired comitant esotropia

“…As the condition progresses, diplopia may gradually appear even at near. With the proliferation of electronic devices and the prolonged period of working and studying from home due to the COVID-19 pandemic, the incidence of AACE has increased ( 9 , 10 ). In recent years, the majority of AACE patients presenting for treatment have been Type III ( 11 , 12 ).…”