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Authors' Reply

Kothari, Mihir MS

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Indian Journal of Ophthalmology: Jul–Aug 2007 - Volume 55 - Issue 4 - p 319
doi: 10.4103/0301-4738.33056
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Dear Editor,

The reader is right in objecting to our classifying accommodative esotropia under the term ANAET. The five classes given by us are rather a classification of acute esotropia. We apologize to the readers for our error and thank the above reader for highlighting the error. Nevertheless, ANAET is neither a new term coined by us nor should it confuse the clinicians. The term ANAET was in use previously123 and we found it useful and a descriptive term. We do not differentiate ANAET from late onset basic esotropia since diplopia is the only differentiating factor. We believe that the presence of diplopia artificially divides nonaccommodative esotropia into two types. There is no evidence that the absence or presence of diplopia is related to differences in etiopathogenesis or prognosis of late onset nonaccommodative comitant esotropia, all of which can be classified under one generic term. We have included only those patients in whom atropine-based refractive correction did not significantly reduce the esotropia. An overestimation of the prevalence by us is less likely. Several recent studies145 have reported ANAET as a common cause of esotropia (second only to accommodative esotropia) confirming our perception of the high incidence of ANAET as real. In our study the history of diplopia was specifically asked to the patients and the parents. Possible reasons of its absence are mentioned in the discussion section.6 The reference of von Norden's work was given to describe three of the five types of acute comitant esotropia and his suggested etiopathogenesis. The remaining types were included from the work of other investigators.

1. Mohney BG. Acquired nonaccommodative esotropia in childhood J AAPOS. 2001;5:85–9
2. Kitzmann AS, Mohney BG, Diehl NN. Progressive increase in the angle of deviation in acquired nonaccommodative esotropia of childhood J AAPOS. 2003;7:349–53
3. Kitzmann AS, Mohney BG, Diehl NN. Short-term motor and sensory outcomes in acquired nonaccommodative esotropia of childhood Strabismus. 2005;13:109–14
4. Mohney BG. Common forms of childhood esotropia Ophthalmology. 2001;108:805–9
5. Greenberg AE, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia: a population-based study Ophthalmology. 2007;114:170–4
6. Kothari M. Clinical characteristics of spontaneous late-onset comitant acute no accommodative esotropia in children Indian J Ophthalmol. 2007;55:117–20
© 2007 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow