Spontaneous consecutive esotropia

Eye (Lond). 2018 Jul;32(7):1197-1200. doi: 10.1038/s41433-018-0060-0. Epub 2018 Mar 2.

Abstract

Purpose: Although less frequent than consecutive exotropia, consecutive esotropia is a well-known type of strabismus when it follows the surgical correction of an exotropia. Spontaneous conversion from initial constant, large-angle exotropia beyond the age of 3 months to esotropia or orthophoria, however, is not common. We describe a series of infants who presented a spontaneous evolution from a large-angle infantile exotropia to either an orthophoria or a spontaneously consecutive esotropia.

Methods: Cases of infants examined in the pediatric neuro-ophthalmology clinic of a tertiary ophthalmology department between 2009 and 2015, and having presented an early large-angle exotropia that spontaneously converted into an esotropia or orthophoria-i.e., without any previous surgery or botulinum toxin injection-were studied.

Results: Ten cases (6 M:4 F) were followed up. Median age at first exotropia assessment was 3.88 months (SD = 6.35). Median age at spontaneous conversion to esotropia or orthophoria was 7.23 months (SD = 14.73). Six patients suffered from severe neurologic or metabolic diseases, three had neonatal respiratory distress syndrome, and one was healthy.

Conclusion: Spontaneous conversion from initial large-angle exotropia to esotropia or orthophoria can be encountered. The cerebral maturation of visual structures probably accounts for this uncommon strabismus sequence.

MeSH terms

  • Esotropia / etiology*
  • Exotropia / complications
  • Female
  • Humans
  • Hyperopia / complications
  • Infant
  • Infant, Newborn
  • Male
  • Nervous System Diseases / complications
  • Retrospective Studies