Untreated essential infantile esotropia: factors affecting the development of amblyopia. 1998

C Calcutt, and A D Murray
Department of Ophthalmology, Charing Cross Hospital, Fulham Palace Road London, UK.

OBJECTIVE A concomitant esotropia, presenting within the first 6 months of life, associated with a high incidence of dissociated vertical deviation, manifest latent nystagmus and asymmetric optokinetic nystagmus is termed essential infantile esotropia. Most studies concern patients diagnosed in infancy and treated throughout childhood. This paper addresses the factors that may influence the development of amblyopia in patients who remain untreated until visual adulthood. METHODS During a 3 year period 113 patients aged 8 years or more with a history of esotropia occurring within the first 6 months of life were examined for the study. All patients underwent full ocular motility assessment and cycloplegic refraction, and only those with one or more signs of essential infantile esotropia were included. RESULTS Of the 113 patients, 16 (14.3%) had a difference of 2 or more lines in the visual acuity of the two eyes and were diagnosed as having amblyopia. Anisometropia was present in 10 of the 16 (62.5%). The correlation between anisometropia and amblyopia was statistically significant (p = 0.0001). CONCLUSIONS Amblyopia following early surgical intervention in essential infantile exotropia is well documented, but the risk is outweighed by the chance of obtaining some form of binocular vision. However, where access to ongoing therapy is not available, patients with essential infantile esotropia, free alternation and no anisometropia have a significant chance of retaining good visual acuity in both eyes if surgery is delayed until visual adulthood.

UI MeSH Term Description Entries
D008134 Long-Term Care Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. Care, Long-Term,Long Term Care
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003906 Developing Countries Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. LMICs,Less-Developed Countries,Low Income Countries,Low and Middle Income Countries,Lower-Middle-Income Country,Middle Income Countries,Third-World Countries,Under-Developed Countries,Developing Nations,Least Developed Countries,Less-Developed Nations,Third-World Nations,Under-Developed Nations,Countries, Middle Income,Countries, Third-World,Country, Least Developed,Country, Less-Developed,Country, Low Income,Country, Lower-Middle-Income,Country, Middle Income,Country, Third-World,Country, Under-Developed,Developed Country, Least,Developing Country,Developing Nation,Least Developed Country,Less Developed Countries,Less Developed Nations,Less-Developed Country,Less-Developed Nation,Low Income Country,Lower Middle Income Country,Lower-Middle-Income Countries,Middle Income Country,Nation, Less-Developed,Nation, Third-World,Nation, Under-Developed,Third World Countries,Third World Nations,Third-World Country,Third-World Nation,Under Developed Countries,Under Developed Nations,Under-Developed Country,Under-Developed Nation
D004948 Esotropia A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. Esophoria,Strabismus, Convergent,Strabismus, Internal,Convergent Strabismus,Cross-Eye,Esodeviation,Intermittent Esotropia,Internal Strabismus,Monocular Esotropia,Primary Esotropia,Secondary Esotropia,Cross Eye,Cross-Eyes,Esodeviations,Esophorias,Esotropia, Intermittent,Esotropia, Monocular,Esotropia, Primary,Esotropia, Secondary,Esotropias,Intermittent Esotropias,Monocular Esotropias,Primary Esotropias,Secondary Esotropias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000550 Amblyopia A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivation-induced amblyopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. STRABISMUS and REFRACTIVE ERRORS may cause this condition. Toxic amblyopia is a disorder of the OPTIC NERVE which is associated with ALCOHOLISM, tobacco SMOKING, and other toxins and as an adverse effect of the use of some medications. Anisometropic Amblyopia,Lazy Eye,Amblyopia, Developmental,Amblyopia, Stimulus Deprivation-Induced,Amblyopia, Suppression,Stimulus Deprivation-Induced Amblyopia,Amblyopia, Anisometropic,Amblyopia, Stimulus Deprivation Induced,Amblyopias,Amblyopias, Anisometropic,Amblyopias, Developmental,Amblyopias, Stimulus Deprivation-Induced,Amblyopias, Suppression,Anisometropic Amblyopias,Deprivation-Induced Amblyopia, Stimulus,Deprivation-Induced Amblyopias, Stimulus,Developmental Amblyopia,Developmental Amblyopias,Eye, Lazy,Eyes, Lazy,Lazy Eyes,Stimulus Deprivation Induced Amblyopia,Stimulus Deprivation-Induced Amblyopias,Suppression Amblyopia,Suppression Amblyopias
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014792 Visual Acuity Clarity or sharpness of OCULAR VISION or the ability of the eye to see fine details. Visual acuity depends on the functions of RETINA, neuronal transmission, and the interpretative ability of the brain. Normal visual acuity is expressed as 20/20 indicating that one can see at 20 feet what should normally be seen at that distance. Visual acuity can also be influenced by brightness, color, and contrast. Acuities, Visual,Acuity, Visual,Visual Acuities

Related Publications

C Calcutt, and A D Murray
March 2018, Journal of pediatric ophthalmology and strabismus,
C Calcutt, and A D Murray
June 2002, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus,
C Calcutt, and A D Murray
January 1990, Journal of pediatric ophthalmology and strabismus,
C Calcutt, and A D Murray
January 1991, Journal of pediatric ophthalmology and strabismus,
C Calcutt, and A D Murray
December 1998, Perceptual and motor skills,
C Calcutt, and A D Murray
February 1988, Investigative ophthalmology & visual science,
C Calcutt, and A D Murray
February 1977, The New England journal of medicine,
C Calcutt, and A D Murray
October 2017, Klinische Monatsblatter fur Augenheilkunde,
C Calcutt, and A D Murray
January 2017, Seminars in ophthalmology,
C Calcutt, and A D Murray
November 1997, Archives of ophthalmology (Chicago, Ill. : 1960),
Copied contents to your clipboard!