INFERIOR OBLIQUE OVERACTION IN INFANTILE ESOTROPIA - FUNDUS EXTORSIONAS A PREDICTIVE SIGN

Background: Inferior oblique overaction develops in 72% of patients wi th infantile esotropia but generally is not recognized until the patie nt is between 2 and 4 years of age. Methods: While undergoing bilatera l medial rectus recessions, photographs were taken of the posterior po le of 27 eyes in 14 patients with infantile esotropia and graded for t he presence or absence of torsion by a masked observer. Follow up rang ed from 10 months to 6 years. Results: Oblique muscle overaction devel oped in 15 of the 27 eyes. Of these 15, six demonstrated fundus torsio n in infancy, before the oblique dysfunction was recognized clinically . Conclusion: The presence of abnormal fundus torsion can serve as a m arker for patients with infantile esotropia who ultimately will develo p overt oblique muscle dysfunction.