Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
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Case #23 Acquired Esotropia
History
Case 1:
An 8 month old boy is noted by parents to have an intermittent esotropia. Upon examination, developmental cataracts are noted in both eyes. Lensectomies and anterior vitrectomies were performed OU. The esotropia persisted after cataract removal.
Case 2
A 3 year old girl presents to you with a history of esotropia of recent onset. Her refractive error is +6.75 + 0.50 x 35 OD.
Case 3
A 48 year old woman presents to you with an onset of diplopia of 2 weeks and inability to abduct her left eye.
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Question #1
What diagnostic tests should be performed for each of the above types of acquired esotropia?
Question #2
What are the causes of adult onset esotropia?
Question #3
What are the clinical characteristics seen in patients with the type of ocular motility disorder shown in case C?
Question #4
Why is the refractive error important in case B? Why are repeat cycloplegic refractions needed?
Question #5
Why is a complete medical history needed when examining patients such as case C?
References
Scott WE, Werner DB, Lennarson LW: Evaluation of Jensen procedures by saccades and diplopic fields. Arch Ophthalmol 1979; 97: 1886-1889.
Acquired Esodeviation. In: Pediatric Ophthalmology & Strabismus, 1987-1988. Section 6 of the Basic and Clinical Science Course. San Francisco, American Acad of Ophthalmology 1987.