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Common forms of childhood esotropia
1Division of Ophthalmology, Department of Surgery and the Department of Pediatrics, East Tennessee State University, James H. Quillen College of Medicine, Box 70575, Johnson City, TN 37614, USA. mohney@etsu.edu
Insights
Accommodative esotropia is the most common form of childhood eye misalignment, affecting over half of young patients. Congenital esotropia is significantly less common than other types.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Childhood esotropia encompasses various subtypes with differing etiologies and prognoses.
- Understanding the prevalence of each type is crucial for diagnosis and treatment planning.
Purpose of the Study:
- To identify and quantify the most frequent forms of esotropia in children under 11 years of age.
- To establish the relative frequency of different esotropia subtypes in a defined pediatric population.
Main Methods:
- Prospective, consecutive, observational case series.
- Evaluation of 221 esotropic children under 11 years without prior surgery.
- Collection of demographic and clinical data.
Main Results:
- Accommodative esotropia was the most prevalent form, diagnosed in 52.9% of patients.
- Central nervous system abnormalities (17.2%) and acquired nonaccommodative esotropia (10.4%) were the next most common.
- Congenital esotropia was relatively uncommon (5.4%).
Conclusions:
- Accommodative esotropia significantly outweighs congenital esotropia in frequency among young patients.
- Esotropia associated with CNS defects or acquired nonaccommodative deviations are more common than congenital forms.
- Paralytic and sensory esotropia were found to be relatively rare in this cohort.
Objective:
To determine the most common forms of childhood esotropia.
Design:
Prospective, consecutive, observational case series.
Participants:
All esotropic children younger than 11 years of age from a predominantly rural Appalachian region evaluated from August 1, 1995 through July 31, 1998.
Methods:
Demographic and clinical data were collected for all patients.
Main Outcome Measures:
The percentage ratio of the various forms of childhood esotropia.
Results:
Two hundred twenty-one consecutive children without prior surgical treatment were evaluated for esotropia. One hundred seventeen (52.9%) of the 221 children had some form of accommodative esotropia, 38 (17.2%) were associated with congenital or acquired abnormalities of the central nervous system, 23 (10.4%) displayed acquired nonaccommodative esotropia, 15 (6.8%) resulted from ocular sensory defects, 12 (5.4%) had confirmed congenital esotropia, seven (3.2%) had paralytic esotropia, and an unverified age at onset prevented an accurate categorization in the remaining nine (4.1%).
Conclusions:
Children with accommodative esotropia accounted for more than half of the study patients and were diagnosed nearly 10 times more frequently than children with congenital esotropia. Esotropic patients with central nervous system defects or with an acquired nonaccommodative deviation were also more common than children with congenital esotropia. Children with congenital esotropia or with a paralytic or sensory cause of their deviation were relatively uncommon.
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