title: Progressive increase in the angle of deviation in acquired nonaccommodative esotropia of childhood.
abstract: OBJECTIVE
  Although the angle of deviation in patients with congenital esotropia has been shown to increase during the early preoperative period, few data exist regarding this change in other forms of childhood esotropia. The primary objective of this study was to investigate whether the angle of deviation increases with time in patients with acquired nonaccommodative esotropia (ANAET).
  
  
  METHODS
  The medical records of all children whose ANAET was diagnosed at East Tennessee State University College of Medicine from August 1, 1995, through October 1, 2001, were retrospectively reviewed. All patients were assessed for any change in the amount of their strabismic angle and associated risk factors.
  
  
  RESULTS
  Eighty-two patients with ANAET were identified, and all except 3 underwent more than one examination. Of the 79 children who underwent more than one examination, 26 (32.9%) displayed an angle increase of > or =10 prism diopters (PD) during a median follow-up period of 2.9 months. The ANAET of those patients whose angle increased by > or =10 PD was diagnosed (28.4 months of age vs 45.5 months of age, P =.003), and they underwent surgery (35.9 months of age vs 53.3 months of age, P =.003) at a significantly younger median age than those whose angle increased <10 PD.
  
  
  CONCLUSIONS
  The angle of deviation of approximately one third of patients with ANAET in this study increased at least 10 PD in the early preoperative period. This increase occurs more often in younger patients and underscores the importance of performing serial measurements of the deviating angle before surgical intervention is undertaken.
authors.affiliation: Department of Ophthalmology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Kitzmann
authors.forename: Brian G
authors.initials: BG
authors.lastname: Mohney
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Diehl
mesh_terms: D000065:Accommodation, Ocular; D002675:Child, Preschool; D018450:Disease Progression; D004948:Esotropia / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies