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Oxybutynin-associated esotropia
Elaine Y H Wong1, Anton Harding, Lionel Kowal
1Ocular-Motility Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia. e.wong@unimelb.edu.au
Summary
Oxybutynin, used for enuresis, can trigger esotropia in children with hyperopia by reducing accommodation. Correcting hyperopia and stopping oxybutynin resolved the esotropia.
Area of Science:
- Ophthalmology
- Pediatrics
- Pharmacology
Background:
- Hyperopia is a common refractive error in children.
- Enuresis is often treated with anticholinergic medications like oxybutynin.
- Anticholinergic drugs can affect accommodation, the eye's ability to focus.
Observation:
- A 5-year-old girl with undiagnosed hyperopia developed esotropia during oxybutynin treatment.
- The esotropia resolved after discontinuing oxybutynin and correcting her hyperopia.
- A small esophoria remained after hyperopic correction removal.
Findings:
- Oxybutynin's anticholinergic effect likely reduced accommodative ability.
- This reduction in accommodation increased accommodative convergence.
- The imbalance between accommodation and convergence triggered esotropia.
Implications:
- Anticholinergic medications should be used cautiously in children with uncorrected hyperopia.
- Esotropia may be an iatrogenic effect of oxybutynin in susceptible individuals.
- Early detection and correction of hyperopia are crucial for preventing vision disorders.
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