{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:00Z","timestamp":1787022120184,"version":"build-2736575974"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Purpose<\/jats:title>\n To analyze epidemiology, clinical features, and surgical outcomes of type III acute acquired concomitant esotropia (Bielschowsky esotropia (BE)).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The medical charts of patients diagnosed with acquired concomitant esotropia between 2013 and 2021 were reviewed. Assessed data were age, gender, age at diplopia onset, age at the diagnosis, refraction, visual acuity, neuroimaging, diplopia onset, angle of deviation, stereopsis, surgical procedure, amount of surgery, and relapse of diplopia after surgery. Moreover, we investigated the correlation between the use of electronic devices and the onset of diplopia.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n One hundred seventeen patients (mean age 35.07 \u00b1 15.81 years) were included in the study. The mean delay to the diagnosis was 3.29 \u00b1 3.62 years. Myopia range was 0 to 17 diopters spherical equivalent. 66,3% spent more than 4 hours a day using laptops, tablets, or smartphones at the onset of diplopia, and 90,6% presented a subacute onset. None showed neurologic signs or symptoms. Patients who underwent surgery were ninety-three, with a rate of surgical success of 93.6%, and a relapse rate of 17.2%. A negative correlation resulted between pre-operative deviation and age at diagnosis (\u03c1 = -0.261; p<0.05), whereas factors associated with surgical failure were older age at diplopia onset (p = 0.042) and longer delay between onset and diagnosis (p = 0.002).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n We registered an outstanding increase in prevalence of BE, which could be related to the exponential increase in the use of electronic devices for professional, educational, and recreational purposes. A prompt diagnosis and an augmented dose of surgery allows good motor and sensory results.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0280968","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T13:33:23Z","timestamp":1684416803000},"page":"e0280968","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["Epidemiology, clinical features, and surgical outcomes of acute acquired concomitant esotropia associated with myopia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-8608","authenticated-orcid":true,"given":"Matilde","family":"Roda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"di Geronimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3887-7655","authenticated-orcid":true,"given":"Nicola","family":"Valsecchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Gardini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Fresina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Vagge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Schiavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"pone.0280968.ref001","first-page":"1","article-title":"Clinical characteristics and risk factors of acute acquired concomitant esotropia in last 5 years: a retrospective case\u2013control study","author":"M Zhu","year":"2022","journal-title":"Eye"},{"issue":"Pt 2","key":"pone.0280968.ref002","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/0002-9394(58)90223-X","article-title":"Comitant convergent strabismus with acute onset","volume":"45","author":"HM Burian","year":"1958","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0280968.ref003","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.jcjo.2020.10.006","article-title":"Augmented bimedial rectus muscles recession in acute acquired concomitant esotropia associated with myopia","volume":"56","author":"M Roda","year":"2021","journal-title":"Can J Ophthalmol"},{"key":"pone.0280968.ref004","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.2147\/OPTH.S307951","article-title":"Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management","volume":"15","author":"A Lekskul","year":"2021","journal-title":"Clin Ophthalmol"},{"issue":"4","key":"pone.0280968.ref005","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.4103\/ijo.IJO_2813_21","article-title":"Acute acquired comitant esotropia precipitated by excessive near work during the COVID-19-induced home confinement.","volume":"70","author":"R Neena","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"pone.0280968.ref006","article-title":"Association between near viewing and acute acquired esotropia in children during tablet and smartphone use","author":"E Van Hoolst","year":"2022","journal-title":"Strabismus"},{"issue":"3","key":"pone.0280968.ref007","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1080\/09273972.2021.1948072","article-title":"Series of cases of acute acquired comitant esotropia in children associated with excessive online classes on smartphone during COVID-19 pandemic; 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