Non Accommodative ET

Let me tell you how we can manage non-accommodative esotropia (ET). Well, the approach in managing patient with non-accommodative ET may differ according to the case. Here are some useful guideline for you.

Presentation

• ET same for N and D
• No improvement with plus correction.
• Normal AC/A ratio
• Amblyopia is common
• Onset: 2 years of age - even in late adulthood.
• BSV is weak
• Full duction

Differential diagnosis

• Breakdown of an esophoria (most common)
• 6th nerve paresis
• Myasthenia gravis
• Tyroid eye disease.

Management

• Conservative treatments such as vergence therapy, prism are usually not effective
• Surgery is required: bilateral medial rectus recession

*it is not that easy to treat this kind of patient, after the strabismus surgery, patient might end up with diplopia. So, what should we do? Comment and share your opinion.

source: Miss Melanie Yeoh, orthoptist.