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Age-related distance esotropia.
1Advocate Lutheran General Hospital/Advocate Lutheran General Children's Hospital, Park Ridge, Illinois, USA. mittelmd@yahoo.com
Summary
Age-related distance esotropia is a newly described condition in older adults. This acquired strabismus, characterized by greater esotropia at distance than near, is effectively managed with prisms, avoiding surgery in most cases.
Area of Science:
- Ophthalmology
- Geriatric Medicine
- Neuro-Ophthalmology
Background:
- Acquired esotropia can manifest in older adults.
- A specific subtype, age-related distance esotropia, is characterized by differing near and distance deviations.
Purpose of the Study:
- To describe a distinct form of acquired esotropia in older individuals.
- To term this condition "age-related distance esotropia".
Main Methods:
- Retrospective review of 26 consecutive patients diagnosed with age-related distance esotropia.
- Analysis of patient age, distance and near deviation measurements, and ocular motility.
Main Results:
- Patients aged 62-91 years (median 77) presented with esotropia greater at distance (median 9 PD ET) than near (median 3 PD ET).
- Full ductions and versions were noted, with no evidence of lateral rectus paresis or obvious neurological disorders.
- Prismatic correction successfully eliminated distance diplopia in all patients, and no surgical intervention was required.
Conclusions:
- Age-related distance esotropia is a unique strabismus presentation in the elderly.
- The etiology is presumed to be age-related anatomical changes in ocular muscles or orbit.
- Prism prescription is an effective primary treatment, though surgery may be necessary in some instances.