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Of 128 patients reviewed with binocular dysfunction, 30 (23.4%) had acute acquired concomitant esotropia (AACE). These patients complained of sudden onset diplopia at distance with no or moderate problems at near. There was no previous history of strabismus. Mean age was 29.7 ±10.3 years. There were 17 males and 13 females. The time period from onset to accessing treatment was 0.94 ±0.38 years. Mean cyclo refraction was -5.25 ±1.67D; 28 were myopic and two emmetropic. All had BCVA of 0.0 logMAR. Concomitant esotropia measured 35.8 ±14.17PD at distance and 26.23 ±11.46PD at near. All had normal binocular single vision and all were treated with Fresnel prisms of a mean strength of 5.0 ±0.7PD to the right and 4.8 ±0.8PD to the left eye. The authors discuss the increase in frequency of AACE alongside an increase in smartphone use. They conclude prisms are a good treatment alternative in the early stage of AACE presentation.

Prism treatment of acute acquired concomitant esotropia precipitated by visual confusion.
Chang F, Wang T, Yu J, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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