Case Studies: Sudden onset esotropia

This article focuses on two patients who presented with a recent onset esotropia, both linked to extraocular muscle malfunction. The first concerns a very young child with an unusual cause for concern related to her adoption of habitual forced convergence, the second an elderly patient with lateral rectus damage due to bone metastases from his prostate cancer.

A three-year-old female patient, AD, was booked in as an emergency appointment following the concerns of both AD’s mother and nursery teacher who noticed she had developed a convergent strabismus, apparently overnight. AD seemed unable to overcome the strabismus and her mother was very worried, unaware of any family history of squint or any traumatic insult to AD that might have preceded the problem.