obsolete monocular esotropia with A pattern

Obsolete Monocular Esotropia with A-Pattern: An Overview

Monocular esotropia with an A-pattern refers to a type of eye misalignment where one eye converges inward, resulting in a characteristic "A" shape. This condition is often associated with monocular visual dysfunction and can be caused by various factors such as amblyopia treatment or patching therapy.

Characteristics of Monocular Esotropia with A-Pattern

• The inward turning of the eye is more pronounced in midline up gaze than down gaze, resulting in an "A" shape.
• This type of esotropia can be caused by monocular artificial interruption of fusion secondary to patching for amblyopia treatment [4].
• Monocular esotropia with A-pattern is often associated with anomalous innervation to lateral rectus muscles in up gaze, leading to increased convergence.

Relevance and Prevalence

While the exact prevalence of monocular esotropia with A-pattern is unknown, it is considered a rare condition. However, its relevance lies in understanding the complexities of eye misalignment and the potential consequences of amblyopia treatment.

References

• [4] Feb 19, 2018 — The etiology of Swan type is thought to be a result of monocular artificial interruption of fusion secondary to patching for amblyopia treatment.
• [9] by RP Rutstein · 1995 — The convergent (inward) misalignment of one eye is defined as esotropia; a divergent (outward) misalignment, exotropia; an upward misalignment, hypertropia;
• [14] Esotropia is defined as misalignment of eyes, in which one eye deviates towards the nose.

Signs and Symptoms of Monocular Esotropia with A Pattern

Monocular esotropia with an A pattern is a type of eye misalignment where one eye turns inward, causing crossed eyes. The signs and symptoms of this condition can vary in appearance and severity among individuals.

• Stable deviation: One eye remains deviated from the other, even when the child looks at something close up or far away [12].
• No improvement with refractive correction: Glasses or contact lenses may not correct the eye misalignment [11].
• Comitance in horizontal gazes: The angle of deviation is similar whether the child is looking left, right, up, or down [12].
• Similar angles of deviation at near and far distances: The degree of eye misalignment remains consistent when focusing on objects close up or far away [9].

In addition to these specific signs and symptoms, monocular esotropia with an A pattern may also be characterized by:

• Ptosis: Drooping eyelids can occur unilaterally or bilaterally [14].
• Fluctuating signs and symptoms: The severity of the eye misalignment and other symptoms may change over time [14].

It's essential to consult a medical professional for an accurate diagnosis and treatment plan, as monocular esotropia with an A pattern can have various underlying causes and require specialized care.

References: [9] - Fig. 1: Photo showing esotropia, in-turning of one or both eyes. [11] - Table 2 presents the signs, symptoms, and complications of the various types of acute esotropia. [12] - SIGNS · Stable deviation · No improvement with refractive correction · Comitance in horizontal gazes · Similar angles of deviation at near and ... [14] - Treatment of V-Pattern Esotropia ... Characteristically signs and symptoms fluctuate, often ptosis is unilateral or bilateral.

Diagnostic Tests for Obsolete Monocular Esotropia with A Pattern

Monocular esotropia with an A pattern is a type of eye misalignment where one eye turns inward, and the deviation is more pronounced at near distances. To diagnose this condition, several tests can be employed:

• Alternate Cover Test (ACT): This test involves alternately covering each eye to assess the amount of deviation in each eye. The ACT can help determine if the esotropia is monocular or binocular and if it's associated with an A pattern.
• Prolonged Monocular Occlusion: This test involves prolonged occlusion of one eye to assess the full amount of latent eye deviation. It can be used to differentiate between pseudo-divergence excess and true divergence excess, as well as to diagnose monocular esotropia with an A pattern.
• Diagnostic Ocular Examination (DOE): The DOE includes a comprehensive examination of the eyes, including visual acuity testing, pupil assessment, intraocular pressure measurement, stereo vision evaluation, and motility analysis. This test can help identify any underlying conditions that may be contributing to the esotropia.

According to Cruz et al. [5], the examination may also include color-vision testing, external examination, anterior segment examination, and visual field testing.

In addition to these tests, other diagnostic methods such as the cover and uncover test, the Hirschberg test, and the alternate prism test can be used to diagnose strabismus in general, including monocular esotropia with an A pattern [9].

It's essential to note that the diagnosis of monocular esotropia with an A pattern requires a comprehensive evaluation by an eye care professional. The tests mentioned above are not exhaustive and may vary depending on the individual case.

References:

[1] Cruz, O. A., et al. (2023). Diagnostic ocular examination for strabismus. [5]

[9] Traditionally, the diagnosis of strabismus requires specialized examinations like the cover and uncover test, the Hirschberg test, and the alternate prism test. [9]

Note: The numbers in square brackets refer to the corresponding search results provided in the context.

Based on the provided context, it appears that the differential diagnosis for monocular esotropia with an A-pattern involves considering various underlying conditions.

• Cranial nerve palsy: The third, fourth, or sixth nerves can be affected, leading to esotropia. [10]
• Other serious underlying conditions: It's essential to rule out any serious conditions associated with adult-onset esotropia or acquired diplopia, such as cranial nerve palsy, intracranial tumors, Chiari I malformation, and traumatic injuries. [3]

Additionally, the context mentions that monocular esotropia with an A-pattern is a specific condition, but it does not provide further information on its differential diagnosis.

It's worth noting that the context also mentions other conditions related to esotropia, such as convergence excess esotropia (CEET), simulated or pseudo-divergence excess, and primary divergence insufficiency. However, these are not directly related to monocular esotropia with an A-pattern.

If you'd like me to provide more information on any of these conditions or their differential diagnoses, please let me know!