Acute acquired comitant esotropia precipitated by excessive near work during the COVID-19-induced home confinement

Purpose: To evaluate the causes of acute acquired comitant esotropia (AACE) in young adults and children in the setting of COVID?19?induced home confinement. Methods: A retrospective, clinical study of all patients, who presented to the Pediatric Ophthalmology and Strabismus services of a tertiary eye care center in South India from August 2020 to January 2021 during the COVID?19 pandemic, with acute?onset, comitant esotropia. Results: 11 (73.3%) of the total 15 patients were students, above 10 years and with a mean age of 16.8 years. 12 patients (80%) had more than 8 hours of near activity a day with a mean duration of 8.6 hours per day. The most common near activity was online classes, followed by job?related work and mobile games, and 86.7% used smartphones for near work. The average esotropia was 22.73 prism diopter (PD) for distance and 18.73 PD for near. Majority (66.6%) had hyperopia with basic or divergence insufficiency esotropia, and the remaining 33.3% had myopia and fitted in to the Bielschowsky type AACE. There was no precipitating event other than sustained near work in all, except in one patient who also had fever prior to the onset of esotropia. Conclusion: The habit of long?time and sustained near work, especially on smartphones, may increase the risk of inducement of AACE

Interpretation and discussion of 2016 American Association of Clinical Endocrinologists guideline for obesity / 中华内分泌代谢杂志

In 2016, American Association of Clinical Endocrinologists(AACE) published the guidelines for obesity and defined obesity as an adiposity-based chronic disease and obesity should be managed according to the obesity-related complications (16 complications are listed). Obesity intervention should be transferred from the purpose of weight loss to the intervention of metabolic disorder and its complications. The diagnosis and intervention of obesity in this guideline is sub- classified focus on the gender, region, and combined diseases, which is with more practical and scientific significances. This interpretation is expected to help the professional medical staffs to understand the new strategy in obesity therapy and to combine with the real world and clinical experience. New suggestions should put forward and improve the theories.