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Letter to the Editor
Spontaneous consecutive exotropia in children with motor fusion
  1. CLIFFORD R WEIR
  1. Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, UK
  2. Deparment of Orthoptics
  3. Tennent Institute of Ophthalmology
  1. MARIE CLEARY
  1. Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, UK
  2. Deparment of Orthoptics
  3. Tennent Institute of Ophthalmology
  1. GORDON N DUTTON
  1. Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, UK
  2. Deparment of Orthoptics
  3. Tennent Institute of Ophthalmology
  1. Dr Weir

https://doi.org/10.1136/bjo.85.2.238e

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    Editor,—The development of spontaneous consecutive exotropia is not uncommon in patients with esotropia.1They characteristically have an early onset partially accommodative esotropia associated with poor binocular function including weak motor fusion, which is thought to prevent stable eye alignment. We report the findings in five patients with partially accommodative esotropia who developed spontaneous consecutive exotropia despite having adequate motor fusion.

    CASE REPORTS

    We reviewed the case records of five children with partially accommodative esotropia who attended the orthoptic clinic within the department of ophthalmology and were noted to have developed spontaneous consecutive exotropia despite having motor fusion. Each child had undergone cycloplegic refractions, with full hypermetropic correction prescribed. A full orthoptic and ophthalmic examination had also been performed. None had any significant medical history of note.

    The findings are summarised in Table 1. The mean age of presentation of the esotropia was 2½ years (range 1½–3¾), with the mean size of the esodeviation being 33 prism dioptres for near (range 15–50) without spectacle correction. Accurate data were not consistently available for the distance deviation at this time owing to the young age of the children. The mean refractive error (spherical equivalent) was +6.6 dioptres for the right eye (range +4.00 to +8.75) and …

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