ETIOLOGY AND PROGNOSIS OF ACUTE, LATE-ONSET ESOTROPIA

Objective: The purpose of the study is to review etiologies and outcom es of sudden, late-onset esotropia, Design: The authors reviewed chart s of patients in whom acute, comitant, constant esotropia developed af ter 5 years of age. Main Outcome Measures: The authors evaluated final ocular alignment, treatment, fusion, apparent etiologies, and associa ted neurologic conditions, Results: Ten patients met entry criteria wi th documentation of previous orthotropia. Ages ranged from 5 to 35 yea rs. Esotropia at near ranged from 16 to 70 prism diopters. In seven pa tients, the esotropia improved partially or completely with correction of hypermetropia. Eight patients required surgery, In only one patien t were neuroimaging studies positive, associated ophthalmic and system ic findings identified, and underlying neurologic disease diagnosed. C onclusions: Sudden, late-onset esotropia may be caused by an uncorrect ed refractive error. If no other neurologic signs are present, underly ing intracranial disease is unlikely.