Rutstein R P
School of Optometry/Medical Center, University of Alabama, Birmingham 35294.
J Am Optom Assoc. 1988 Jun;59(6):446-9.
Acute acquired comitant esotropia in the older child, adolescent, and young adult may represent uncorrected accommodative esotropia. Three young patients developed spontaneous diplopia associated with acute comitant esotropia. In all cases, cycloplegic refraction revealed high uncorrected hyperopia suggesting late onset accommodative esotropia. However, for one patient an intracranial neoplasm precipitated the strabismus and for the other patients the hyperopic correction did not alter the deviation. Clinicians confronted with older children or adolescent patients with acute comitant esotropia associated with large uncorrected hyperopia should not hastily classify the deviation as being accommodative in etiology. Although the latter is possible, the hyperopia may be coincidental and masking an underlying mechanism.
大龄儿童、青少年及青年成人的急性后天性共同性内斜视可能代表未经矫正的调节性内斜视。三名年轻患者出现了与急性共同性内斜视相关的自发性复视。在所有病例中，睫状肌麻痹验光显示有高度未矫正远视，提示为迟发性调节性内斜视。然而，一名患者因颅内肿瘤引发了斜视，而其他患者的远视矫正并未改变斜视度数。面对患有急性共同性内斜视且伴有高度未矫正远视的大龄儿童或青少年患者时，临床医生不应草率地将斜视病因归类为调节性。虽然后者有可能，但远视可能只是巧合，掩盖了潜在的病因机制。
