Etiology and prognosis of acute, late-onset esotropia.

OBJECTIVE

The purpose of the study is to review etiologies and outcomes of sudden, late-onset esotropia.

DESIGN

The authors reviewed charts of patients in whom acute, comitant, constant esotropia developed after 5 years of age.

MAIN OUTCOME MEASURES: The authors evaluated final ocular alignment, treatment, fusion, apparent etiologies, and associated neurologic conditions.

RESULTS

Ten patients met entry criteria with documentation of previous orthotropia. Ages ranged from 5 to 35 years. Esotropia at near ranged from 16 to 70 prism diopters. In seven patients, the esotropia improved partially or completely with correction of hypermetropia. Eight patients required surgery. In only one patient were neuroimaging studies positive, associated ophthalmic and systemic findings identified, and underlying neurologic disease diagnosed.

CONCLUSIONS

Sudden, late-onset esotropia may be caused by an uncorrected refractive error. If no other neurologic signs are present, underlying intracranial disease is unlikely.