title: Treatment of acute comitant esotropia in Chiari I malformation.
abstract: 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.
authors.affiliation: University of Florida, Department of Ophthalmology, Gainesville, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Weeks
authors.forename: L M
authors.initials: LM
authors.lastname: Hamed
mesh_terms: 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