Outcomes for acute acquired non-accommodative comitant esotropia
Reviewed by Fiona Rowe

Outcomes are reported in a retrospective review of 338 patients with acute acquired non-accommodative comitant esotropia (AACE). Mean age at presentation was 12.60 ±9.37 years and 220 were male, 118 female. Best corrected visual acuity was 0.2 ±0.29 logMAR overall; 0.25 ±0.2 in children and 0.1 ±0.12 in adults. Cycloplegic refraction was done for 289 (85.5%). Mean hypermetropia was 1.56DS and mean myopia was -2.60DS. Myopic patients were older than hypermetropic patients; 14.8 ±8.1 years vs. 6.4 ±3.66 years. Twenty-two percent reported diplopia at presentation. Neuroimaging was available for 67.73% of which 83.7% were normal and 16.3% had incidental findings such as nonspecific white matter hyperintensities. Surgery was undertaken for 44.5%. Overall success was 71%. Only one patient had significant overcorrection whilst 25.5% had recurrent / residual esotropia. Slightly more surgical success was found in adults than children. The rate of surgical success was less if patients had delayed treatment. There was similar success for small vs. moderate vs. large angle esotropia. In general, AACE was noted in 4.9% of their childhood esotropia population.

Clinical profile, neuroimaging characteristics and surgical outcomes of patients with acute acquired non-accommodative comitant esotropia.
Sheth J, Goyal A, Natarajan D, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60(3):218-25.