Spontaneous consecutive sensory esotropia: a case series

We present the first case series of patients with no systemic neurologic disease who experienced a spontaneous conversion from an initial exotropia to a sensory esotropia in the absence of strabismus surgery or chemodenervation. The patients in this series all were exotropic in the first 2 years of life, with the strabismic eye having decreased vision due to unilateral ocular pathology. All patients demonstrated spontaneous conversion to esotropia between 4 and 8 years of age and thereafter clinically demonstrated a high ratio of accommodative convergence to accommodation. There was no discernible relationship between refractive error and the pattern of spontaneous esotropia. The existence of this rare entity may support delayed surgical correction of strabismus in patients with sensory exotropia.