Evaluation and surgical outcome of acquired nonaccommodative esotropia among older children

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Acquired nonaccommodative esotropia (ANAET) is a rare condition in older children.
• Diplopia is a common and distressing symptom for affected individuals.

Purpose of the Study:

• To detail the clinical characteristics, diagnostic process, surgical treatment, and outcomes for children over 8 years old with ANAET.
• To evaluate the efficacy of surgical intervention for this specific patient group.

Main Methods:

• Retrospective review of medical records for patients diagnosed with ANAET and treated surgically.
• Inclusion criteria: age > 8 years at onset, spontaneous comitant esotropia, and bilateral medial rectus recession surgery.
• Data collected included clinical presentation, diagnostic work-up, surgical details, and pre- and post-operative deviation measurements.

Main Results:

• Seven patients meeting the criteria were identified, with an average age of onset at 11.9 years.
• All patients reported diplopia and presented with large-angle esotropia.
• Post-operative assessment showed complete resolution of diplopia and excellent stereopsis in all seven patients.

Conclusions:

• Diplopia is the primary symptom prompting medical attention in older children with ANAET.
• Bilateral medial rectus recession surgery is a highly effective treatment for ANAET in this age group, leading to excellent functional outcomes.