Acute concomitant esotropia of adulthood

Purpose: To identify the characteristics of adult patients who develop acute concomitant esotropia of adulthood. Design: Retrospective noncomparative case series. Participants: Ten patients were included in this study. Intervention: The charts of all adults with acute-onset concomitant esotropia who were examined at our institute between 1990 and 1997 were reviewed, and those who had developed the syndrome when they were older than the age of 16 years were included in this study. All participants underwent a complete ocular and physical examination, including brain and orbital computed tomography. Main Outcome Measures: Angle of esotropia, measured by the prism and cover test. Results: The mean age +/- standard deviation at the time of the ocular and physical examination was 38 18.6 years (range, 18-70 years). The mean myopic error was -4.1 +/- 3.2 diopters (range, +2.0 to -8.5 diopters). Nine of the 10 patients were myopic. The mean angle of esotropia was 33.8 +/- 14.7 prism diopters (range, 18-60 prism diopters). The mean period of follow-up was 2.2 +/- 1.0 years (range, 1-4 years). After surgery, all patients were orthophoric or minimally esophoric, and in all of them, stereoacuity (measured by the Titmus stereofly test) was 40 arc seconds. Conclusions: In a well-defined group of adult patients with acute-onset concomitant esotropia, almost all were myopic, and all regained normal stereopsis after surgery. Acute concomitant esotropia of adulthood should probably be classified as a distinct subgroup of acute-onset esotropia.