Acute comitant esotropia in a very young child due to combined mechanism: A case report

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Neuro-ophthalmology

Background:

• Esotropia, a form of strabismus, can be associated with high hyperopia in young children.
• Accommodative esotropia is a common type of esotropia in hyperopic children, often managed with refractive correction.

Observation:

• A 3-year-old female with high hyperopia presented with esotropia.
• Initial treatment with hyperopic correction resulted in partial accommodative esotropia.
• The child later developed headaches and was diagnosed with an intracranial tumor.

Findings:

• Surgical removal of the intracranial tumor led to the resolution of the non-accommodative component of esotropia.
• The intracranial lesion was identified as an additional causative factor for the acute onset esotropia.
• The child achieved orthophoria with her existing hyperopic correction post-tumor removal.

Implications:

• Intracranial lesions should be considered in the differential diagnosis of acute onset esotropia, even in the presence of high hyperopia.
• Prompt diagnosis and management of intracranial pathologies can impact ocular alignment in pediatric patients.
• This case highlights the complex interplay between neurological conditions and visual development.