Clinical characteristics and treatment outcomes of myopic children and adolescents with acute acquired comitant esotropia

CLINICAL RELEVANCE: Acute acquired comitant esotropia (AACE) is becoming increasingly common in young children. Understanding clinical characteristics and treatment outcomes can inform future practice. BACKGROUND: To evaluate clinical characteristics of myopic children and adolescents with AACE, and the outcomes of varying treatments. METHODS: A retrospective review of medical records was conducted to identify patients diagnosed with AACE and diplopia between 2016 and 2020. The duration of smartphone use, angle of deviation, refractive error, stereopsis, and treatment options were analysed. The motor outcomes were evaluated at the earliest 6-month postoperative visit (6-30 months), and orthotropia or esodeviation ≤10 prism dioptres (PD) was defined as success. Successful sensory outcomes were defined as the elimination of diplopia in primary gaze or the presence of stereoacuity. RESULTS: < 0.001, for both). Eight patients required surgery and were treated with bilateral medial rectus muscle recession, two patients were treated with botulinum toxin, and two patients were followed with prismatic glasses. Nine of 10 patients (%90) treated with either surgery or botulinum toxin had successful motor and sensory outcomes. CONCLUSIONS: Surgery is the most efficient treatment option; botulinum toxin and prismatic glasses could be useful treatment options in patients who refuse to have surgery or for whom the amount of deviation is small and variable.