Esotropia

• What is consecutive SOT likely caused by?

  Over liberal surgery or deliberate undercorrection
• What is secondary/sensory SOT associated with?

  Pathology and often loss of foveal function
• What characterizes primary SOT?

  Primary problem is SOT itself
• How does accommodative SOT differ from non-accommodative SOT?

  Deviation increases at near in accommodative SOT
• What is partially accommodative SOT associated with?

  Hyperopia and increased deviation without lenses
• What is infantile SOT characterized by?

  Onset before 6 months of age
• What is the significance of cross fixation in infantile SOT?

  It indicates the use of the opposite eye
• What is dissociated vertical divergence (DVD)?

  Eyes drift upwards spontaneously after covering
• What is nystagmus and how does it behave in SOT?

  Increases on dissociation and abduction
• What is compensatory head posture (CHP)?

  Face turns to fixing eye to reduce nystagmus
• What does the assessment of binocular function reveal in SOT?

  Unlikely to have any binocular vision
• What is the difference between non-accommodative SOT and late onset non-accommodative SOT?

  Late onset occurs between 2-8 years
• What is the relationship between SOT and myopia?

  High myopia increases prevalence of SOT
• What characterizes fully accommodative SOT?

  Eyes are straight with full hyperopic correction
• How does convergence excess SOT manifest?

  Excessive convergence when accommodating
• What is the significance of near SOT?

  Manifest at near while controlled at distance
• What is cyclic SOT?

  Depends on time when esotropic or not
• What factors are important in the history of SOT?

  Eye direction, frequency, and duration of SOT
• What is the commonality of amblyopia in constant SOT?

  Common, except if freely alternating
• How does amblyopia therapy work for children under 7?

  Ensures no worsening of vision occurs
• What is the purpose of the cover test?

  Differentiates types of SOT
• What does ocular motility assessment reveal in SOT?

  May show underactions or overactions of muscles
• What is the best method for measuring angle in SOT?

  PCT (Prism Cover Test)
• How is controlled binocular acuity assessed?

  By reading down a chart until SOT occurs
• What is the significance of assessing AC/A ratio?

  Indicates control in convergence excess SOT
• What do Bagolini lenses assess in constant SOT?

  Diplopia, suppression, and abnormal retinal correspondence
• What is the purpose of the post-operative diplopia test?

  To assess candidacy for surgery
• What is the role of refraction in SOT management?

  To correct ametropia and significant refractive error
• What is the first stage of esotropia management?

  Improve vision through refraction and therapy
• What is the conservative management approach for SOT?

  Observation, optical aids, and exercises
• What is the role of botulinum toxin in SOT management?

  Paralyzes muscle to reduce deviation temporarily
• When should children under 5 be referred to HES?

  For constant monitoring and management
• What is the management for constant SOT with an accommodative element?

  Cycloplegic refraction and amblyopia treatment
• What is the management for fully accommodative SOT?

  Cycloplegic refraction and full correction
• What exercises are used for management of small hyperopic Rx?

  Exercises to maintain single vision while accommodating
• What is the management for convergence excess SOT?

  Correct refractive error and treat amblyopia
• What is the role of bifocals in convergence excess SOT management?

  Extra plus for near to achieve good BSV
• What is the contraindication for bifocals in SOT management?

  Large deviation and very high AC/A ratio
• What is the follow-up for post-operative bifocals?

  Monitor for SOT during accommodation
• What are the types of SOT?

  Consecutive, secondary, and primary SOT