Abstract
We present an audit of the clinical characteristics and strabismus surgery outcomes for Acute Acquired Commitant Esotropia (AACE) cases managed by our paediatric ophthalmology team at the Royal Victoria Infirmary, UK.
A retrospective review of 29 AACE cases. We describe the age of onset, angle of deviation, and surgical outcome measurements including the amount of deviation and the prevalence of resolved diplopia. We also describe the percentage of patients who were sent for neuroimaging upon presentation.
Medical records of 29 AACE cases (males=20, females=9) between January 2017 and August 2020 were reviewed. Mean age of presentation was 9 years (range 5-15 years). Preoperative deviation angles were 38.1 ± 13.6 prism dioptres (PD) (range= 14-70 PD). While 19 patients reported diplopia (65.5%), 3 had no diplopia and 4 patients had no mention of it in their records. Neuroimaging was requested for 18 patients (62%) and they were all normal. Eighteen cases underwent bilateral medial rectus recession, while unilateral medial rectus recession and lateral rectus resection were performed for 11 cases. Mean follow-up was 8.4 ± 13 months. Mean postoperative angles were 4±4.8 PD (range 0-18 PD). Twenty-four patients (88.8%) had postoperative angles within 10 PD. Diplopia was resolved in 17 patients (89.6%). Postoperative results allowed us to retrospectively reclassify 12 cases (41.3%) as decompensated microtropia (Type IV AACE).
Our surgical and functional results were comparable to outcomes in the literature. Though none of our patients had an intracranial pathology, it should be considered in all AACE cases.