Clinical profile of esotropia patients in a tertiary care center with application of the CEMAS classification

Abstract

Abstract Aims: This studyaims to study the clinical profile of patients with esotropia (ET) in a tertiary care centre. Materials and Methods: A cross-sectional observational study was carried out on 94 patients with ET seen in the ophthalmology outpatient department of a tertiary care center from December 2018 to June 2020. Results: A female preponderance was noted with male:female ratio of 0.8:1. Although 79 patients (84.04%) had noticed the onset of ET in the first decade of life, only 50 (53.19%) of the patients presented to the ophthalmologist in the first decade of life. Family history of ET was present in only 7.44% of patients. Amblyopia was present in 31 (32.97%) patients. The most common refractive error seen was hypermetropia followed by hypermetropic astigmatism. Based on the Classification for Eye Movement Abnormalities and Strabismus (CEMAS), there were 36 (40.42%) patients with refractive accommodative ET, 15 (15.95%) of infantile ET, 13 (13.82%) patients had ET due to visual/neurological disease, 16 (15.95%) patients had cranial neuropathy and there was one child with neuromuscular cause – Duane’s retraction syndrome (Type 1). Conclusion: Most of the patients in the study sought consultation for the management of ET late in life though it was noticed in early childhood. Majority of the patients had refractive accommodative ET. These can be managed appropriately if diagnosed early. A significant number of patients had amblyopia as sequelae of untreated ET. Early diagnosis and appropriate management at the right time are very important in patients with ET to prevent the development of amblyopia and maintain binocularity.