TY - JOUR T1 - Acute onset comitant esotropia as presenting sign of demyelinating disease JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 1194 LP - 1194 DO - 10.1136/bjo.83.10.1194l VL - 83 IS - 10 AU - BARRY N WASSERMAN Y1 - 1999/10/01 UR - http://bjo.bmj.com/content/83/10/1194.5.abstract N2 - Editor,—Comitant esotropia is most often acquired at an early age, and is generally benign. However, acute comitant esotropia has also been reported in patients with intracranial diseases including hydrocephalus, Arnold-Chiari malformations, and central nervous system tumours. I describe a case of acute onset comitant esotropia associated with acute demyelinating disease. CASE REPORT An 11 year old boy was referred for evaluation of diplopia. The patient stated he woke up the previous day with double vision. He denied decreased visual acuity, photophobia, pain with eye movements, headache, or nausea and vomiting. One week before the onset of esotropia, he had an upper respiratory infection with a fever that resolved without antibiotics. His mother also noted that he had been very tired over the previous week with episodes of falling asleep during the day at home and school, and one episode of dizziness. He was an otherwise healthy child on no medications and with no allergies. On examination, visual acuity without correction was 20/20 bilaterally. Pupils … ER -