ABSTRACT
@#AIM:To describe the clinical characteristics of 20 patients with acute acquired comitant esotropia(AACE). <p>METHODS: This retrospective, observational case series study enrolled patients with AACE examined from June 2018 to May 2021 in Guangdong Jiangmen Central Hospital. The age when attacked, the duration of excessive near work before illness, symptom, refraction, AC/A, deviation and near stereopsis were analyzed. All 20 patients had unremarkable neurological finding by imageological test. <p>RESULTS: Most patients whose mean age was 24.25±5.78 years immersed in near work for more than 6h a day before illness. All patients seeked for medical help because diplopia with normal ocular motility in all directions of gaze and meaningless finding in routine ophthalmologic examinations. They were all nearsightedness whose mean spherical equivalent was -5.73±5.09D, while mean AC/A was 2.65±1.16 within the upper limit. There was no different between the distant and near deviations(<i>P</i>>0.05). Deviations might be correlated with near stereopsis(<i>P</i><0.05), however the duration from onset to treatment was irrelevant(<i>P</i>>0.05).<p>CONCLUSION: The clinical features of AACE in older children and adults who immersed excessive near work are medium myopia, diplopia, normal ocular motility, no neurological finding and limited AC/A. Moreover, it is approximate between distant and near deviations. The deviations affect near stereopsisd more, while the influence of duration from onset to treatment may be less.
ABSTRACT
PURPOSE: To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia. METHODS: We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia. RESULTS: A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence. CONCLUSIONS: Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.
Subject(s)
Female , Humans , Male , Emmetropia , Esotropia , Follow-Up Studies , Medical Records , Prognosis , Recurrence , Refractive Errors , Retrospective Studies , SmartphoneABSTRACT
PURPOSE: To describe the new type of acute comitant estropia with dual cause of fusional dysfunction due to occlusion and refractive-accommodative factors. METHODS: We experienced two case of acute, acquired comitant esotropia in the course of occlusion therapy. The patients had mild hyperopia and severe accommodative tendency. RESULTS: After strabismus surgery, the patients have orthophoria and stereopsis recovery. CONCLUSIONS: We believe that the patients with acute comitant esotropia and abrupt diplopia should undergo thorough ophthalmological, neurological evaluations. And, acute comitant esotropia might occur during the occlusion therapy for amblyopia.