Treatment of acute comitant esotropia in Chiari I malformation.
OBJECTIVE
To explore the appropriate treatment of acute comitant esotropia in patients with Chiari I malformation.


METHODS
Interventional case reports and literature review.


METHODS
Two patients with Chiari I malformation presenting with acute comitant esotropia are described.


METHODS
Strabismus surgery, then neurosurgical decompression of the Chiari I malformation was performed.


METHODS
Both patients were evaluated for resolution of esotropia and other ocular motility problems.


RESULTS
After initially successful strabismus surgery, both patients developed recurrent esotropia with diplopia, which resolved on suboccipital decompression.


CONCLUSIONS
Comitant esotropia may recur and other eye movement disorders may develop after initially successful strabismus surgery in patients with Chiari I malformation. The data suggest that the appropriate sequence of treatment should first be suboccipital decompression, then strabismus surgery if spontaneous realignment does not occur, but further studies are needed to confirm this impression.
Weeks
C L
CL
University of Florida, Department of Ophthalmology, Gainesville, USA.
Hamed
L M
LM
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D002531:Cerebellum / Q000473:pathology; D019299:Decompression, Surgical; D004948:Esotropia / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence