obsolete intermittent monocular esotropia

Obsolete Intermittent Monocular Esotropia

Intermittent monocular esotropia, also known as intermittent esotropia of one eye, is a type of strabismus where the eye deviates inwardly towards the nose, but only occasionally. This condition can affect one eye and is characterized by an intermittent inward deviation of the eye.

Causes

The exact cause of intermittent monocular esotropia is not well understood, but it is believed to be related to a reduction in visual acuity, reduced visual function, high refractive error, or traumatic brain injury [4][5][6].

Symptoms

Symptoms of intermittent monocular esotropia may include double vision, headaches, eyestrain, nausea, dizziness, and blurred vision. Clinical signs may also be present, such as esophoria greater at distance than near, low AC/A ratio [7].

Types

There are several types of esotropia, including intermittent monocular esotropia, constant esotropia, infantile or congenital esotropia, and convergence excess esotropia. Intermittent monocular esotropia is a type of intermittent esotropia that affects one eye [10][11].

Treatment

The treatment for intermittent monocular esotropia may involve glasses, prisms, or surgery to straighten the eyes. In some cases, bifocal glasses or surgery may be prescribed to correct the condition [13][15].

Note: The term "obsolete" in the description refers to the fact that the code 194101008 is from SNOMEDCT version 2019-03, which is an older version of the code system.

Common Signs and Symptoms of Obsolete Intermittent Monocular Esotropia

Intermittent monocular esotropia is a type of strabismus where one eye turns inward intermittently. The symptoms can vary from person to person, but here are some common signs and symptoms associated with this condition:

• Diplopia: Double vision or blurred vision in the affected eye [4]
• Eye strain and pain: Patients may experience eye fatigue, headaches, and discomfort due to the constant shifting of focus between the two eyes [9]
• Decreased balance or depth perception: The misalignment can affect the brain's ability to process visual information, leading to difficulties with balance and depth perception [6]
• Blurred vision: The affected eye may experience blurred vision or difficulty focusing on objects [11]

Other Symptoms

In addition to these common symptoms, patients with intermittent monocular esotropia may also experience:

• Ptosis: Drooping of the eyelid in the affected eye [7]
• Fluctuating signs and symptoms: The severity and frequency of symptoms can vary throughout the day or over time [8]

Important Note

It's essential to seek medical attention if you're experiencing any of these symptoms, as early diagnosis and treatment can help alleviate discomfort and prevent long-term vision problems.

References:

[1] Not applicable (context does not contain relevant information)

[2-15] Refer to the context provided for relevant information.

Based on the provided context, it appears that there are several diagnostic tests used to identify and diagnose various types of esotropia, including intermittent monocular esotropia.

• Alternate Cover Test: This test is used to measure the horizontal deviation in the non-fixating eye. It involves shifting the occluder from one eye to the other while measuring the movement of the eyes (1). The alternate cover test can be used to differentiate between constant and intermittent esotropia, as well as to quantify the deviation (4).
• Prolonged Monocular Occlusion: This test is used to suspend fusion and uncover the full amount of a latent eye deviation. It involves prolonged monocular occlusion, which was developed by Marlow to diagnose esophoria, exophoria, or even esotropia (10). Prolonged monocular occlusion can be an effective way to suspend fusion and measure the deviation.
• Diagnostic Monocular Occlusion Test: This test plays a critical role in classifying types of esotropia. It involves measuring the horizontal deviation in the non-fixating eye using alternate cover testing, followed by shifting the occluder back to the non-fixating eye (14).
• Reversed Fixation Test: This test is used as an initial confirmatory test for DHD (Duane's Retraction Syndrome). After measuring the horizontal deviation in the non-fixating eye using alternate cover testing, the occluder is shifted back to the non-fixating eye, which normally shows no movement because the horizontal deviation has already been neutralized by the prism (12).

These diagnostic tests are used to identify and diagnose various types of esotropia, including intermittent monocular esotropia. It's essential to note that each test has its specific application and should be performed under the guidance of an experienced ophthalmologist.

References: (1) Patch Test - The patch test is used to control the tonic fusional convergence to differentiate pseudo-divergence excess from true divergence excess and to... (4) by BC Black · 2006 · Cited by 74 — Cover-uncover testing was used to distinguish constant from intermittent esotropia, and the deviation was quantified with prism and alternate cover testing... (10) The most effective ways to suspend fusion are the alternate cover test and prolonged monocular occlusion. 3,4 Prolonged monocular occlusion was developed by Marlow to uncover the full amount of a latent eye deviation. (12) This is because full correction of the distance deviation may result in persistent esotropia at near 9. Diagnostic monocular occlusion test plays a critical role in classifying these types... (

Based on the provided context, it appears that there are some outdated treatments for intermittent monocular esotropia.

Part-time monocular atropine therapy: According to search result [6], part-time monocular 1% atropine therapy has been used to control intermittent exotropia in young children. However, this treatment is not commonly recommended due to its limited effectiveness and potential side effects.

Botulinum toxin type A: Search result [9] mentions that botulinum toxin type A has been used to paralyze the extraocular muscles and treat intermittent exotropia. However, this treatment is generally not preferred due to its temporary nature and potential complications.

It's worth noting that these treatments are considered obsolete or not commonly recommended for several reasons:

• Limited effectiveness: Search result [7] states that non-surgical treatments for intermittent exotropia are not very effective.
• Potential side effects: Atropine therapy can have side effects such as blurred vision, headaches, and eye irritation (search result [6]).
• Temporary nature: Botulinum toxin type A treatment is temporary and may require repeated injections to maintain its effect.

Current recommendations: The current recommended treatments for intermittent exotropia are surgical interventions, such as strabismus surgery, or botulinum toxin injections in some cases. These treatments have been shown to be more effective and longer-lasting than the obsolete treatments mentioned above.

References:

• [6] Part-time monocular 1% atropine therapy for intermittent exotropia control in young ...
• [7] Although the non-surgical treatment for intermittent exotropia is not very effective but it may be preferred in patients with small (<20pd) deviations, very ...
• [9] by K Wang · 2022 — Medications are generally not used to treat intermittent exotropia, with the exception of botulinum toxin type A, which has been used to paralyze over ...

The differential diagnosis for obsolete intermittent monocular esotropia involves considering various conditions that may present with similar symptoms. Based on the search results, here are some possible differential diagnoses:

• Monocular elevation deficiency: This is a condition where one eye has difficulty elevating, which can cause intermittent esotropia (1).
• Consecutive exotropia: This is a type of strabismus that occurs when there is a significant difference in the refractive power between the two eyes, leading to intermittent esotropia (15).
• Accommodative esotropia: This is a type of esotropia that occurs due to excessive accommodation, which can cause intermittent monocular esotropia (7, 11).
• Duane syndrome: This is a rare congenital condition characterized by limited eye movement and strabismus, which can present with intermittent monocular esotropia (15).
• Brown syndrome: This is another rare congenital condition that affects the superior oblique muscle, leading to limited eye movement and strabismus, including intermittent monocular esotropia (15).

It's essential to note that these differential diagnoses are not exhaustive, and a comprehensive evaluation by an ophthalmologist or orthoptist is necessary to determine the underlying cause of obsolete intermittent monocular esotropia.

References:

• [1] Search result 10: Esotropia is defined as misalignment of eyes, in which one eye deviates towards the nose.
• [7] Search result 7: An intermittent angle of esotropia generally occurs in association with accommodative esotropia or decom- pensated esophoria (a tendency of one eye to deviate inward).
• [11] Search result 11: Intermittent esotropia occurs at regular intervals, classically every other day.
• [15] Search result 15: A list of the differential diagnoses of esotropia organised by non-accommodative or incomitant.