Tuesday, November 2, 2010

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.


  • 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.


  • 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.

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