Abstract
Purpose :
While consecutive esotropia typically occurs following surgical correction of exotropia, spontaneous consecutive esotropia is a rarely described entity. We present a series of neurologically normal children who demonstrated a spontaneous conversion from exotropia to esotropia.
Methods :
This retrospective chart review examined all neurologically normal patients seen by one physician in the Northwell Department of Ophthamlology between 2002 and 2019 who demonstrated an exotropia which spontaneously converted to esotropia. Four patients were identified.
Results :
The median age of first ophthalmologic evaluation was 13.5 months (SD = 9.33). The median age of spontaneous conversion to esotropia was 77 months (SD=27.61 months). One patient first demonstrated an esotropia which spontaneously converted to exotropia and then back to esotropia. All patients had poor vision in the strabismic eye. Two patients suffered from optic nerve hypoplasia, one demonstrated morning glory disc anomaly, and one demonstrated persistent hyperplastic primary vitreous with an abnormal retinal architecture. All patients demonstrated a larger esotropic deviation at near compared to distance.
Conclusions :
This is the first series of neurologically normal patients who demonstrate spontaneous consecutive esotropia. All patients had in common poor vision in one eye and larger esotropic deviations at near compared to distance. The larger deviations at near suggests that spontaneous consecutive esotropia may be related to the development of accommodative convergence.
This is a 2020 ARVO Annual Meeting abstract.