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Title

Distance Esotropia in the Elderly

Purpose	To describe the clinical findings of small esodeviation with horizontal diplopia on distance fixation, seen in elderly patients and not associated with lateral rectus underaction or with any currently known neurological abnormalities.
Methods	Eighty-five elderly patients, age 62 till 91, with permanent or intermittent horizontal diplopia at distance were prospectively evaluated from February 2008. Ocular alignment, fusion amplitudes and horizontal eye movements were measured at distance and near.
Results	Distance esodeviation varied from 2 prism dioptres (PD) esotropia (ET) to 18 PD ET. At near fixation, the deviation ranged from 10 PD exophoria to 12 PD esophoria. Divergence fusional amplitude at distance ranged from 0 PD to 10 PD while the divergence fusional amplitude at near ranged from 2 PD to 18 PD. Horizontal ductions and versions were full in all patients. All patients were successfully treated with prisms, ranging from 2 PD base out to 16 PD base out.
Conclusion	Our findings indicate that elderly patients with distance esotropia may have a slight increase in their distance esodeviation over time, with slow decrease of fusional divergence amplitude and with normal ocular motility, being successfully treated with prisms for many years.

Authors 1

Last name	GODTS
Initials	DJM
Department	Universitair Ziekenhuis Antwerpen, Afdeling OOgheelkunde
City	Edegem