Adult-Onset Comitant Esotropia: Patient Characteristics and Medical Evaluation

Area of Science:

• Ophthalmology
• Neuro-ophthalmology

Background:

• Adult-onset comitant esotropia (AOCET) is a condition affecting eye alignment in adults.
• Understanding its demographics and clinical presentation is crucial for diagnosis and management.

Purpose of the Study:

• To categorize the demographics, clinical profile, and medical work-up findings in adult-onset comitant esotropia (AOCET).

Main Methods:

• Retrospective study of 268 adult patients with AOCET.
• Exclusion criteria included history of childhood strabismus, prior surgery, trauma, concussion, or other neurologic symptoms.
• Analysis by age of onset and refractive error.

Main Results:

• Mean age was 53.7 years; 62.7% were women.
• Mean refractive error was -3.22 diopters, with myopia prevalent in younger patients and hyperopia increasing with age of onset.
• Mean distance esotropia was 17.2 prism diopters, inversely related to age of onset.
• An etiology was identified in only 6.7% of patients, with few new diagnoses.

Conclusions:

• AOCET predominantly affects White women and is often associated with myopia.
• Systemic work-ups for thyroid eye disease, myasthenia gravis, and neuroimaging infrequently reveal an underlying cause for AOCET.