Adult esotropia

Esotropia is a condition where one or both eyes turn inward. Approximately 1 to 2 percent of all people in the United States have esotropia, according to the College of Optometrists in Vision Development. Esotropia can take several forms, with some types developing in infancy and others occurring in adulthood. The infantile form of the condition begins during the first year of life.

Acute acquired comitant esotropia AACE can be a diagnostic challenge for ophthalmologists and neurologists because of its association with neurological pathologies. Our study describes a series of adult patients with AACE of undetermined etiology. Data on the clinical findings of patients presented with AACE of undetermined etiology with a minimum follow-up of 1 year were retrieved from the medical records and the results analyzed. A series of 9 esotropia cases age range: 20—43 years was reviewed. All patients had full duction and versions, without an A-pattern or V-pattern.

Figure 3. Grey tracing represents the target step. Black tracing represents the positions of the right and left eyes. Rightward movements are shown as upward deflections and leftward movements as downward deflections. Figure 4.

Adult esotropia does not only affect quality of vision and stereopsis, but can have great emotional and social effects on a patient. We have to be careful to identify the cause of the esotropia and obtain imaging studies when necessary, but many times there is no clearly identifiable cause. Patients with esotropia can also present to our offices in the context of previous strabismus surgery or a decompensation. Often, the only option presented to a patient is surgical intervention, but other options should be presented as well. Treatment options for esotropia can include surgical intervention, compensating prism in glasses, or vision therapy.