Optometry & Vision Science

Skip Navigation LinksHome > March 2013 - Volume 90 - Issue 3 > Adult-Onset Cyclic Esotropia: A Case Report
Optometry & Vision Science:
doi: 10.1097/OPX.0b013e31828159bf

Adult-Onset Cyclic Esotropia: A Case Report

Di Meo, Antonio*; Costagliola, Ciro*; Della Corte, Michele*; Romano, Antonio*; Foria, Consuelo; Di Costanzo, Alfonso*

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Purpose: This case report presents the diagnosis and management of an adult patient with cyclic esotropia, a rare and poorly understood form of strabismus, that is characterized by alternating periods of manifest strabismus and orthotropia. Few cases of adult-onset cyclic strabismus have been reported. The etiology, pathogenesis, and treatment for this condition are reviewed.

Case Report: A 37-year-old man with high unilateral myopia and anisometropic amblyopia in his left eye developed cyclic esotropia 2 months after a scleral buckle procedure for a retinal detachment. A 48-hour cycle that consisted of a 24-hour period of orthotropia followed by a 24-hour period of constant left esotropia was present. Magnetic resonance imaging, electromyography, electroencephalography, and ocular and orbital echography were unremarkable, as was a neurological assessment that included fatigue and edrophonium testing. The patient was successfully managed with muscle surgery.

Conclusions: The etiology and pathogenesis of adult-onset cyclic esotropia remain unknown. Cyclic esotropia should be considered in the differential diagnosis when an individual presents with a history of intermittent strabismus that is present some days and not others.

© 2013 American Academy of Optometry


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