title: Persistent binocular diplopia in childhood following successful treatment for esotropia: a case series.
abstract: BACKGROUND
  Diplopia is rare in children with nonpathological esotropia because facultative suppression develops prior to visual maturation. Our aim is to present five cases of children with binocular diplopia following treatment of childhood esotropia, exploring possible mechanisms for the development of diplopia based upon the patient's history and findings, and discussing treatment for diplopia in this setting.
  
  
  METHODS
  A retrospective chart review of five sequential patients presenting with binocular diplopia following treatment of esotropia was performed. Treatment of esotropia included correction of hyperopic error, correction of anisometropic amblyopia to 20/30 or better, and strabismus surgery as indicated.
  
  
  RESULTS
  Diplopia developed in two children with accommodative esotropia, one child with infantile esotropia and partially accommodative esotropia, and two children with a history of infantile esotropia and consecutive exotropia following surgical correction. Diplopia onset occurred between ages 7 and 11. Four of the five children experienced resolution of diplopia with prism glasses.
  
  
  CONCLUSIONS
  Children with esotropia before visual maturation may develop persistent diplopia. Clinical features of the children with diplopia in our case series include poor fusion, poor stereopsis, consecutive exotropia, refractive changes, onset of diplopia after 7 years of age, and occlusion therapy for amblyopia. Prisms may be beneficial in controlling the diplopia.
authors.affiliation: From the Hamilton Eye Institute, Memphis, Tennessee.
authors.forename: Tara
authors.initials: T
authors.lastname: Tae
authors.affiliation: From the Hamilton Eye Institute, Memphis, Tennessee.
authors.forename: Chantel
authors.initials: C
authors.lastname: Devould
authors.affiliation: From the Hamilton Eye Institute, Memphis, Tennessee.
authors.forename: Luke
authors.initials: L
authors.lastname: Skilbeck
authors.affiliation: From the Hamilton Eye Institute, Memphis, Tennessee.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Hoehn
authors.affiliation: From the Hamilton Eye Institute, Memphis, Tennessee.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kerr
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology; D002675:Child, Preschool; D004172:Diplopia / Q000209:etiology* / Q000503:physiopathology; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy*; D005139:Eyeglasses; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054140:Refractive Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D015348:Vision, Binocular / Q000502:physiology
keywords: accommodative amblyopia; binocular diplopia; esotropia