Beware: Armed and Dangerous—Acquired Non-Accommodative Esotropia

Abstract

Acquired nonaccommodative esotropia is generally considered to be a benign phenomenon. However, numerous instances of posterior fossa tumors initially presenting as acute comitant esotropia have been reported. The presence of any of the following warrant further investigation when associated with acute onset, nonaccommodative esotropia: nystagmus, vertical strabismus, other cranial nerve involvement, parental concerns of poor motor control, headache or persistent diplopia.

Other types of acquired nonaccommodative esotropia include decompensated esophoria/monofixation syndrome, VI N paresis, divergence paresis, myasthenia gravis and mechanical/restrictive strabismus resulting from Graves disease, trauma, iatrogenesis and orbital myositis are discussed. Clinical investigation and treatment are briefly reviewed.

• acute onset esotropia
• acquired esotropia
• esotropia and pathology
• myositis
• intracranial disease and strabismus