Acute acquired concomitant esotropia and decompensated monofixation syndrome: a sensory-motor status assessment

Purpose: To assess and compare sensory-motor status and clinical features of type I and type II Purpose: To assess and compare sensory-motor status and clinical features of type I and type II acute acquired concomitant esotropia (group A) and decompensated monofixation syndrome (group B). Methods: In a retrospective, comparative study twenty-six patients, with a confirmed postoperative diagnosis of types I and II acute acquired concomitant esotropia and monofixation syndrome, were enrolled. A two-tailed unpaired t-test and a two-tailed chi-square test were performed to compare angle deviation and sensory-motor status under viewing conditions and after prismatic adaptation test and progressive prism test of two groups. Results: All of the patients of group A and 4 patients (33%) of group B complained of diplopia under viewing conditions, at the Worth’s 4 dot and Bagolini striated glasses test. The TNO stereo test showed the total absence of stereopsis in 6 patients in group B and a significantly lower stereoacuity in group A in the remaining six patients (p<0.0001). The Prismatic adaptation test was positive in all of the patients in group B and in 10 patients (71%) in group A (p=0.39). The value of the angle deviation after progressive prism test was significantly higher in group B than group A (p = 0.02). At the end of the progressive prism test all of the patients in group A and only two patients in group B were orthotropic (p=0.01). Conclusions: Bagolini striated glasses and Worth’s 4 dot tests under viewing conditions, and responses under prisms allow for the differentiation of the two forms and lead to an accurate aesthetic and functional prognosis. Keywords: acute acquired concomitant esotropia, decompensated monofixation syndrome, prismatic adaptation test, strabismus, diplopia.