eMedicine Specialties > Ophthalmology > Extraocular Muscles

Esotropia, Infantile: Differential Diagnoses & Workup

Author: Vicente Victor D Ocampo, MD, Consulting Staff, Department of Ophthalmology, Asian Hospital and Medical Center, Philippines
Coauthor(s): C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
Contributor Information and Disclosures

Updated: Feb 27, 2007

Differential Diagnoses

Esotropia and Exotropia, A-patterns
Esotropia and Exotropia, V-patterns
Esotropia, Accommodative
Esotropia, Acquired
Esotropia, Pseudo
Esotropia, with High AC/A Ratio

Workup

Procedures

  • Perform the alternate prism cover test to accurately measure the angle of strabismus. This procedure gauges the full magnitude of any combined esotropia and esophoria. Carefully perform a prism cover testing for both distance and near fixation in primary position, with the patient wearing any prescribed spectacle correction. Measurement of the strabismus also is carried out in side and vertical gazes to rule out restriction, palsy, and significant oblique muscle overaction or underaction.

More on Esotropia, Infantile

Overview: Esotropia, Infantile
Differential Diagnoses & Workup: Esotropia, Infantile
Treatment & Medication: Esotropia, Infantile
Follow-up: Esotropia, Infantile
References
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References

  1. Biglan AW, Burnstine RA, Rogers GL, Saunders RA. Management of strabismus with botulinum A toxin. Ophthalmology. Jul 1989;96(7):935-43. [Medline].

  2. Birch E, Stager D, Wright K, Beck R. The natural history of infantile esotropia during the first six months of life. Pediatric Eye Disease Investigator Group. J AAPOS. Dec 1998;2(6):325-8; discussion 329. [Medline].

  3. Birch EE, Stager DR. Monocular acuity and stereopsis in infantile esotropia. Invest Ophthalmol Vis Sci. Nov 1985;26(11):1624-30. [Medline].

  4. Birch EE, Fawcett S, Stager DR. Why does early surgical alignment improve stereoacuity outcomes in infantile esotropia?. J AAPOS. Feb 2000;4(1):10-4. [Medline].

  5. Chang YH, Ryu IH, Han SH, et al. Intraoperative adjustment in strabismus surgery under topical anesthesia. Yonsei Med J. Oct 31 2006;47(5):667-71. [Medline].

  6. Clarke WN, Noel LP. Vanishing infantile esotropia. Can J Ophthalmol. Jun 1982;17(3):100-2. [Medline].

  7. Friendly DS. Management of infantile esotropia. Int Ophthalmol Clin. 1985;25(4):37-52. [Medline].

  8. Godts D, Trau R, Tassignon MJ. Effect of refractive surgery on binocular vision and ocular alignment in patients with manifest or intermittent strabismus. Br J Ophthalmol. Nov 2006;90(11):1410-3. [Medline].

  9. Greenberg AE, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia: a population-based study. Ophthalmology. Jan 2007;114(1):170-4. [Medline].

  10. Haefliger IO, Safran AB, Mermillod B, Roth A. Inferonasal quadrant of the visual field is not constricted in patients with infantile esotropia when evaluated by means of automated perimetry. J Clin Neuroophthalmol. Jun 1990;10(2):118-20. [Medline].

  11. Hiles DA, Watson BA, Biglan AW. Characteristics of infantile esotropia following early bimedial rectus recession. Arch Ophthalmol. Apr 1980;98(4):697-703. [Medline].

  12. Hunter DG, Ellis FJ. Prevalence of systemic and ocular disease in infantile exotropia: comparison with infantile esotropia. Ophthalmology. Oct 1999;106(10):1951-6. [Medline].

  13. Ing MR. Botulinum alignment for congenital esotropia. Ophthalmology. Mar 1993;100(3):318-22. [Medline].

  14. Ing MR. The timing of surgical alignment for congenital (infantile) esotropia. J Pediatr Ophthalmol Strabismus. Mar-Apr 1999;36(2):61-8; quiz 85-6. [Medline].

  15. Lueder GT, Norman AA. Strabismus surgery for elimination of bifocals in accommodative esotropia. Am J Ophthalmol. Oct 2006;142(4):632-5. [Medline].

  16. McNeer KW, Tucker MG, Spencer RF. Botulinum toxin management of essential infantile esotropia in children. Arch Ophthalmol. Nov 1997;115(11):1411-8. [Medline].

  17. McNeer KW, Spencer RF, Tucker MG. Observations on bilateral simultaneous botulinum toxin injection in infantile esotropia. J Pediatr Ophthalmol Strabismus. Jul-Aug 1994;31(4):214-9. [Medline].

  18. Mohindra I, Zwaan J, Held R, et al. Development of acuity and stereopsis in infants with esotropia. Ophthalmology. May 1985;92(5):691-7. [Medline].

  19. Nixon RB, Helveston EM, Miller K, et al. Incidence of strabismus in neonates. Am J Ophthalmol. Dec 15 1985;100(6):798-801. [Medline].

  20. O'Keefe M, Abdulla N, Bowell R, Lanigan B. Binocular function and amblyopia after early surgery in infantile eosotropia. Acta Ophthalmol Scand. Oct 1996;74(5):461-2. [Medline].

  21. Ohtsuki H, Yoshifumi K, Hasebe S, et al. Comparative study of brain lesions detected by magnetic resonance imaging between strabismus and nonstrabismus in infancy. Ophthalmologica. 2000;214(2):105-10. [Medline].

  22. Paul TO, Hardage LK. The heritability of strabismus. Ophthalmic Genet. Mar 1994;15(1):1-18. [Medline].

  23. Pott JW, Sprunger DT, Helveston EM. Infantile esotropia in very low birth weight (VLBW) children. Strabismus. Jun 1999;7(2):97-102. [Medline].

  24. Pratt-Johnson JA, Tillson G. Sensory results following treatment of infantile esotropia. Can J Ophthalmol. Jun 1983;18(4):175-7. [Medline].

  25. Prieto-Diaz J, Prieto-Diaz I. Long term outcome of treated congenital/infantile esotropia: does early surgical binocular alignment restoring (subnormal) binocular vision guarantee stability?. Binocul Vis Strabismus Q. 1998;13(4):249-54. [Medline].

  26. Robb RM, Rodier DW. The variable clinical characteristics and course of early infantile esotropia. J Pediatr Ophthalmol Strabismus. Nov-Dec 1987;24(6):276-81. [Medline].

  27. Rowe FJ. Long-term postoperative stability in infantile esotropia. Strabismus. Mar 2000;8(1):3-13. [Medline].

  28. Scheiman M, Ciner E, Gallaway M. Surgical success rates in infantile esotropia. J Am Optom Assoc. Jan 1989;60(1):22-31. [Medline].

  29. Scott AB, Magoon EH, McNeer KW, Stager DR. Botulinum treatment of childhood strabismus. Ophthalmology. Nov 1990;97(11):1434-8. [Medline].

  30. Shauly Y, Prager TC, Mazow ML. Clinical characteristics and long-term postoperative results of infantile esotropia. Am J Ophthalmol. Feb 15 1994;117(2):183-9. [Medline].

  31. Shauly Y, Miller B, Meyer E. Clinical characteristics and long-term postoperative results of infantile esotropia and myopia. J Pediatr Ophthalmol Strabismus. Nov-Dec 1997;34(6):357-64. [Medline].

  32. Shirabe H, Mori Y, Dogru M, Yamamoto M. Early surgery for infantile esotropia. Br J Ophthalmol. May 2000;84(5):536-8. [Medline].

  33. Stager DR, Birch EE. Preferential-looking acuity and stereopsis in infantile esotropia. J Pediatr Ophthalmol Strabismus. Jul-Aug 1986;23(4):160-5. [Medline].

  34. Tejedor J, Rodriguez JM. Early retreatment of infantile esotropia: comparison of reoperation and botulinum toxin. Br J Ophthalmol. Jul 1999;83(7):783-7. [Medline].

  35. Ticho BH, Ticho KE, Kaufman LM. Combined strabismus and lens surgery. J AAPOS. Oct 2006;10(5):430-4. [Medline].

  36. Tolun H, Dikici K, Ozkiris A. Long-term results of bimedial rectus recessions in infantile esotropia. J Pediatr Ophthalmol Strabismus. Jul-Aug 1999;36(4):201-5. [Medline].

  37. Tychsen L. Infantile esotropia: Current neurophysiologic concepts. In: Clinical Strabismus Management: Principles and Surgical Techniques. 1999:117-138.

  38. Weakley DR, Urso RG, Dias CL. Asymmetric inferior oblique overaction and its association with amblyopia in esotropia. Ophthalmology. Apr 1992;99(4):590-3. [Medline].

  39. Zak TA, Morin JD. Early surgery for infantile esotropia: results and influence of age upon results. Can J Ophthalmol. Oct 1982;17(5):213-8. [Medline].

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Further Reading

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Keywords

congenital esotropia, infantile esotropia, essential infantile esotropia, strabismus, inward deviation of eyes

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Contributor Information and Disclosures

Author

Vicente Victor D Ocampo, MD, Consulting Staff, Department of Ophthalmology, Asian Hospital and Medical Center, Philippines
Vicente Victor D Ocampo, MD is a member of the following medical societies: American Academy of Ophthalmology and Philippine Ocular Inflammation Society
Disclosure: Nothing to disclose.

Coauthor(s)

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Gerhard W Cibis, MD, Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas, Kansas City
Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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