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20 unusual presentations of accommodative esotropia
Zane F Pollard1, Marc F Greenberg
1Study conducted at the Scottish Rite Children's Medical Center, Children's Health Care of Atlanta, Atlanta, Georgia, USA.
Summary
Unusual accommodative esotropia cases in infants and after trauma highlight the importance of considering this diagnosis. Early intervention with glasses is key, though some may need surgery.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus
Background:
- Accommodative esotropia is a common form of strabismus in children, typically associated with hyperopia.
- This study investigates rare presentations of accommodative esotropia to broaden diagnostic considerations.
Observation:
- Three unusual categories of accommodative esotropia were identified: post-traumatic onset, infantile onset (3-5 months), and onset associated with diabetic ketoacidosis.
- A retrospective review of 20 patients with these atypical histories was conducted.
Findings:
- All patients achieved initial esotropia resolution with corrective lenses (glasses).
- Two patients eventually required surgical intervention years after the initial diagnosis.
Implications:
- Accommodative esotropia should be considered in infants under 5 months with intermittent esotropia or significant hyperopia.
- In cases of trauma-induced esotropia with significant hyperopia, accommodative esotropia is a crucial differential diagnosis.