Acquired distance esotropia associated with myopia

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Strabismology

Background:

• Acquired progressive esotropia, characterized by a larger angle for distance than near, is associated with moderate myopia.
• This presentation differs from esotropia observed in individuals with high myopia.

Purpose of the Study:

• To review and characterize acquired progressive esotropia in patients with moderate myopia.
• To evaluate the efficacy of different treatment modalities for this specific strabismus subtype.

Main Methods:

• Retrospective review of 26 patient records (14 female, 12 male) with acquired progressive esotropia and moderate myopia.
• Analysis of patient demographics, refractive error (mean myopia -5.50 D), presenting symptoms (horizontal diplopia), and treatment history (prisms, botulinum toxin, surgery).

Main Results:

• 17 patients (65%) underwent surgery, primarily unilateral medial rectus recession and lateral rectus resection, achieving diplopia relief.
• Six patients (23%) continued prism correction, while seven (27%) received botulinum toxin injections, with varying success.
• Recurrences were noted in four patients, requiring further intervention or prism use after 6 months to 11 years post-treatment.

Conclusions:

• Acquired progressive esotropia associated with moderate myopia is a benign condition.
• Treatment with prisms or surgery is effective, particularly for patients preferring contact lenses or experiencing inconveniently strong prism corrections.
• While generally successful, long-term monitoring is advisable due to potential recurrences.