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Infantile glaucoma associated with contralateral esotropia
Insights
Esotropia in infants can signal unilateral infantile glaucoma. Early diagnosis and treatment, including surgery and patching, can reverse amblyopia and achieve orthophoria.
Area of Science:
- Ophthalmology
- Pediatrics
- Developmental Pediatrics
Background:
- Esotropia, a form of strabismus, can present in infancy.
- Delayed motor development may warrant further investigation.
Observation:
- A 20-month-old male presented with esotropia noted at four months.
- Ophthalmic evaluation revealed infantile glaucoma and myopia in one eye, and esotropia and amblyopia in the other.
Findings:
- Surgical treatment of infantile glaucoma and patching of the affected eye successfully reversed amblyopia.
- The patient achieved orthophoria, indicating successful alignment of the eyes.
Implications:
- Esotropia can be an early sign of unilateral infantile glaucoma in the contralateral eye.
- A comprehensive evaluation encompassing pediatric, neurologic, and ophthalmic assessments is crucial for diagnosing complex pediatric conditions.
Abstract:
A 20-month-old white male was first seen with an esotropia at four months of age by his pediatrician. The esotropia had been present by history since early in life. After pediatric evaluation, which demonstrated delayed motor development, he was referred for ophthalmic consultation. A comprehensive ophthalmic evaluation established the diagnoses of infantile glaucoma and myopia of the preferred eye, and esotropia and amblyopia of the emmetropic eye. The infantile glaucoma was surgically treated and amblyopia reversed following patching of the glaucomatous eye. Orthophoria was achieved. Esotropia may be the presenting manifestation of unilateral infantile glaucoma of the contralateral eye. Comprehensive appraisal should include pediatric, neurologic, and ophthalmic evaluation.