worse for distance target and less/absent for near fixation
Functional indications include patients with significant anisometropia (unequal refractive error in each eye) and esotropia
(one or more crossed eyes).
On examination, you note the leukocoria and a small right esotropia
Latent nystagmus is typically associated with uniocular neonatal visual defects, particularly infantile (early-onset) esotropia
, whereas infantile nystagmus syndrome is typically associated with visual defects in both eyes.
44,52-54) Furthermore, in patients with surgery for infantile esotropia
, monocular OKN asymmetry persists even though stereopsis has been preserved.
There was also a small esotropia
in the right eye, which had not been noted before; however, the patient did not report diplopia and ocular motility exam was full and normal.
For example, in the esotropia
section there are videos focussing on infantile esotropia
, secondary and consecutive esotropia
, and accommodative and nonaccommodative esotropia
Bifocals are prescribed to children with convergence excess esotropia
, congenital cataract, juvenile stress myopia and Down's syndrome.
Adequate cycloplegic effect could be achieved with tropicamide in a teenage patient suspected of having latent hypermetropia, for example, whereas cyclopentolate is likely to be required for an infant suspected of having an accommodative esotropia