Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Divergence Insufficiency Esotropia Is a Misnomer

Divergence Insufficiency Esotropia Is a Misnomer I read with great interest the recent article by Chaudhuri and Demer titled “Medial Rectus Recession Is as Effective as Lateral Rectus Resection in Divergence Paralysis Esotropia.”1 In 2006, I described a similar cohort of older patients with acquired esotropia greater in the distance than at near fixation.2 I concluded, as they did, that the cause of this disorder is likely secondary to anatomical changes in the orbit and/or muscles associated with aging. Although the patients I detailed in my initial article were all treated with prism glasses, I published a second article3 in 2011 describing good surgical results in another 10 patients with this entity who were treated by adjustable-suture bilateral medial rectus recession, as were the patients described by Chaudhuri and Demer. I also agree with their assertion that the term divergence insufficiency esotropia for this syndrome is a misnomer and that the designation of divergence insufficiency esotropia should be reserved only for those patients with serious neurological disease. Yet, the authors continued to use this older name in their article. I chose to call this entity adult-onset age-related distance esotropia, which I believe better suits the findings we both described. As the population ages, we are certain to see many more patients with this entity, and I hope future investigators will use the more descriptive term of adult-onset age-related distance esotropia rather than the outmoded and inaccurate designation of divergence insufficiency esotropia. Back to top Article Information Correspondence: Dr Mittelman, Pediatric Ophthalmology Adult Strabismus Center, 1875 W Dempster, Ste 610, Park Ridge, IL 60068 (mittelmd@yahoo.com). Conflict of Interest Disclosures: None reported. References 1. Chaudhuri Z, Demer JL. Medial rectus recession is as effective as lateral rectus resection in divergence paralysis esotropia. Arch Ophthalmol. 2012;130(10):1280-128422688183PubMedGoogle Scholar 2. Mittelman D. Age-related distance esotropia. J AAPOS. 2006;10(3):212-21316814172PubMedGoogle ScholarCrossref 3. Mittelman D. Surgical management of adult onset age-related distance esotropia. J Pediatr Ophthalmol Strabismus. 2011;48(4):214-21620795602PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Ophthalmology American Medical Association

Divergence Insufficiency Esotropia Is a Misnomer

JAMA Ophthalmology , Volume 131 (4) – Apr 1, 2013

Loading next page...
 
/lp/american-medical-association/divergence-insufficiency-esotropia-is-a-misnomer-PEaCg0KYHW
Publisher
American Medical Association
Copyright
Copyright © 2013 American Medical Association. All Rights Reserved.
ISSN
2168-6165
eISSN
2168-6173
DOI
10.1001/jamaophthalmol.2013.1584
Publisher site
See Article on Publisher Site

Abstract

I read with great interest the recent article by Chaudhuri and Demer titled “Medial Rectus Recession Is as Effective as Lateral Rectus Resection in Divergence Paralysis Esotropia.”1 In 2006, I described a similar cohort of older patients with acquired esotropia greater in the distance than at near fixation.2 I concluded, as they did, that the cause of this disorder is likely secondary to anatomical changes in the orbit and/or muscles associated with aging. Although the patients I detailed in my initial article were all treated with prism glasses, I published a second article3 in 2011 describing good surgical results in another 10 patients with this entity who were treated by adjustable-suture bilateral medial rectus recession, as were the patients described by Chaudhuri and Demer. I also agree with their assertion that the term divergence insufficiency esotropia for this syndrome is a misnomer and that the designation of divergence insufficiency esotropia should be reserved only for those patients with serious neurological disease. Yet, the authors continued to use this older name in their article. I chose to call this entity adult-onset age-related distance esotropia, which I believe better suits the findings we both described. As the population ages, we are certain to see many more patients with this entity, and I hope future investigators will use the more descriptive term of adult-onset age-related distance esotropia rather than the outmoded and inaccurate designation of divergence insufficiency esotropia. Back to top Article Information Correspondence: Dr Mittelman, Pediatric Ophthalmology Adult Strabismus Center, 1875 W Dempster, Ste 610, Park Ridge, IL 60068 (mittelmd@yahoo.com). Conflict of Interest Disclosures: None reported. References 1. Chaudhuri Z, Demer JL. Medial rectus recession is as effective as lateral rectus resection in divergence paralysis esotropia. Arch Ophthalmol. 2012;130(10):1280-128422688183PubMedGoogle Scholar 2. Mittelman D. Age-related distance esotropia. J AAPOS. 2006;10(3):212-21316814172PubMedGoogle ScholarCrossref 3. Mittelman D. Surgical management of adult onset age-related distance esotropia. J Pediatr Ophthalmol Strabismus. 2011;48(4):214-21620795602PubMedGoogle ScholarCrossref

Journal

JAMA OphthalmologyAmerican Medical Association

Published: Apr 1, 2013

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$499/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month