{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:12:19Z","timestamp":1790251939894,"version":"4.1.0"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Classification and management of acquired concomitant esotropia is controversial. We sought to establish a simple clinical classification in order to determine in which cases further investigations in search of underlying pathologies are necessary.<\/jats:p><jats:p>\n          Patients and Methods Observational retrospective study of the files of 175 consecutive patients examined in our unit between 2009 and 2018 for acute convergent strabismus. One hundred and nine patients were selected, after exclusion of infantile, incomitant, or mechanical esotropias, residual esotropias, and patients examined on a single occasion. All patients received a complete orthoptic and ophthalmological examination. We grouped the patients according to their common characteristics.<\/jats:p><jats:p>\n          Results We established the following categories: 1. Acute esotropia of large angle (20 to 45 prism diopters [PD]), accompanied by mild hyperopia (mean 1.2\u2009D) in children (n\u2009=\u200916) and moderate myopia (mean 3.7\u2009D) in adolescents and adults (n\u2009=\u200913). 2. Decompensated micro-esotropia, which is distinguished from the other categories by the presence of abnormal retinal correspondence (n\u2009=\u200933). 3. Decompensated esophoria, with intermittent deviations of 5 to 30\u2009PD, esotropia being compensated part of the time (n\u2009=\u200925). 4. Esotropia present only at a distance in patients over 50 years of age (n\u2009=\u200920). 5. Small-angle esotropia (&lt;\u200915\u2009PD) greater at a distance, associated with oculomotor cerebellar syndrome (n\u2009=\u20092). Complementary examinations (MRI or CT scan) were performed on 21 patients, leading to the discovery of a posterior fossa astrocytoma in a 4-year-old boy.<\/jats:p><jats:p>\n          Conclusions The recognition of decompensated micro-esotropia and esophoria, as well as distance esotropia of the elderly, avoids unnecessary additional investigations, which are indicated in any type of acute comitant strabismus if associated with any neurological sign or symptom (e.g., headaches, nausea, vertigo, imbalance, poor coordination, nystagmus, or papilledema). In the absence of neurological findings, there is no consensus about the indication of neuroimaging in large-angle acquired concomitant esotropia, but long-term follow-up of patients that do not undergo neuroimaging is strongly recommended in order to identify later occurring intracranial diseases. This is of particular importance with children.<\/jats:p>","DOI":"10.1055\/a-1425-5017","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T22:48:38Z","timestamp":1619822918000},"page":"482-487","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Classification of Acquired Concomitant Esotropia"],"prefix":"10.1055","volume":"238","author":[{"given":"Sara","family":"Gisselbaek","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Hoeckele","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Klainguti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Fran\u00e7ois","family":"Kaeser","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1080\/08820538.2016.1228398","article-title":"Evaluation and Management of Acute Acquired Comitant Esotropia in Children","volume":"32","author":"A L Gilbert","year":"2017","journal-title":"Semin 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of cerebellar dysfunction?","volume":"262","author":"K H\u00fcfner","year":"2015","journal-title":"J Neurol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0079-6123(03)42004-9","article-title":"Effects of lesions of the cerebellar oculomotor vermis on eye movements in primate: binocular control","volume":"142","author":"M Takagi","year":"2003","journal-title":"Prog Brain Res"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"e2273","DOI":"10.1097\/MD.0000000000002273","article-title":"Acute Acquired Concomitant Esotropia: Clinical features, Classification, and Etiology","volume":"94","author":"J Chen","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1136\/bjo.79.5.498","article-title":"Acute onset concomitant esotropia: when is it a sign of serious neurological disease?","volume":"79","author":"C S Hoyt","year":"1995","journal-title":"Br J 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Ophthalmol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ajo.2018.07.007","article-title":"Decompensated Esophoria as a Benign Cause of Acquired Esotropia","volume":"194","author":"M H Ali","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1055\/s-2006-926604","article-title":"Erworbenes Innenschielen im Alter [Acquired esotropia at advanced age]","volume":"223","author":"J A Reichelt","year":"2006","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1136\/bjophthalmol-2013-303139","article-title":"Distance esotropia in the elderly","volume":"97","author":"D Godts","year":"2013","journal-title":"Br J Ophthalmol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1001\/archopht.1989.01070010386029","article-title":"Acute comitant esotropia in children with brain tumor","volume":"107","author":"A 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by a neurological disease","volume":"24","author":"G Dotan","year":"2020","journal-title":"J AAPOS"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12886-019-1182-2","article-title":"Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia","volume":"19","author":"C Cai","year":"2019","journal-title":"BMC Ophthalmol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3928\/01913913-20190206-01","article-title":"Outcomes of Medial Rectus Recession With Adjustable Suture in Acute Concomitant Esotropia of Adulthood","volume":"56","author":"I Garc\u00eda-Basterra","year":"2019","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1111\/aos.13490","article-title":"Acute concomitant esotropia in children","volume":"96","author":"M Sch\u00f6rkhuber","year":"2018","journal-title":"Acta Ophthalmol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1055\/s-0031-1299237","article-title":"Early onset of acquired comitant non-accommodative esotropia in childhood","volume":"229","author":"V Sturm","year":"2012","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jaapos.2011.03.018","article-title":"Long-term follow-up of children with acute acquired concomitant esotropia","volume":"15","author":"V Sturm","year":"2011","journal-title":"J AAPOS"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"117","DOI":"10.4103\/0301-4738.30705","article-title":"Clinical characteristics of spontaneous late-onset comitant acute nonaccommodative esotropia in children","volume":"55","author":"M Kothari","year":"2007","journal-title":"Indian J Ophthalmol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/S0161-6420(97)30136-5","article-title":"Etiology and prognosis of acute, late-onset esotropia","volume":"104","author":"A Legmann Simon","year":"1997","journal-title":"Ophthalmology"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1425-5017.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T22:55:53Z","timestamp":1619823353000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1425-5017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":37,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2021,4,30]]},"published-print":{"date-parts":[[2021,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1425-5017","relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}