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The John Pratt-Johnson Annual Lecture

Consecutive Exotropia Following Surgically Corrected Cyclic Esotropia

Correspondence: Requests for reprints should be addressed to: Joel Post, University of Saskatchewan, c/o Eye Centre, Saskatoon City Hospital, Saskatoon, SK, Canada S7K 0M7; e-mail: joel_post{at}yahoo.com

Introduction: Cyclic esotropia is a rare form of strabismus consisting of regular intervals of esotropia alternating with periods of orthophoria in a rhythmic/cyclic manner. In the vast majority of cases, surgery appears to permanently correct the esotropia, with no sequelae after years of follow-up. We report a case of consecutive exotropia in a patient five years after bilateral medial rectus recessions for cyclic esotropia.

Methods: A case report involving review of a clinical chart.

Results: A two-year-old male presented with right esotropia and mild amblyopia. He was treated with patching and following resolution of the amblyopia he developed a cyclic esotropia. Surgical correction was performed for the full amount measured on a "manifest" day. Following the surgery, he was orthophoric and demonstrated binocular vision. He remained stable for five years, and then returned with occasional diplopia and an intermittent exotropia.

Conclusion: Cyclic esotropia is a rare disorder of ocular motility that spontaneously appears and disappears at regular intervals. After surgical correction, the deviation disappears and recurrence of esotropia is very infrequent. We present the first reported case of consecutive exotropia following surgical correction of a cyclic esotropia.

Key words: consecutive exotropia, cyclic esotropia, strabismus surgery