Divergence Insufficiency Esotropia Associated with Excessive Near Work During the Coronavirus Pandemic
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Updated: Jan 31, 2026

Titration of Human Coronaviruses Using an Immunoperoxidase Assay
Published on: April 28, 2008
Sepideh Tavakolizadeh1, Mohammad Reza Akbari2, Mehdi Khabazkhoob3
1Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
Purpose:
The COVID-19 lockdown has had a profound impact on people's lifestyles - especially the youth - through school closures and home confinement. Accordingly, the excessive use of smartphones and digital devices made adolescents vulnerable to the adverse effects of excessive near work on the eyes.
Method:
Four adolescents (10-17 years) with acute acquired divergence insufficiency esotropia were evaluated.
Results:
The mean age of our patients was 14 years old (10-17). Their mean deviation at distance was 32.5 PD (25-40 PD), and their mean near deviation was 13 PD (8-20 PD). All patients had normal neurological examinations and exhibited normal brain and orbital MRI results. Excessive near work with digital devices such as smartphones after the COVID-19 lockdown was the only risk factor identified. All cases were successfully treated with bilateral lateral rectus resection. A 3.5- to 5.5-mm bilateral lateral rectus resection corrected 25 to 40 PD esotropia at distance without overcorrection at near.
Conclusion:
Decreased outdoor activities and excessive near work during the COVID-19 pandemic could be associated with divergence insufficiency esotropia in adolescents. Bilateral lateral rectus resection is an acceptable surgical treatment.
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