Cyclic esotropia

Cyclic esotropia typically begins during preschool years. Esotropia is present intermittently, usually occurring every other day (ie, a 48-hour cycle). However, variable cycles and 24-hour cycles have been documented. Fusion and binocularity are usually defective on the strabismic day, with marked improvement on the straight day. Diplopia is unusual in pediatric patients with cyclic esotropia.

Cyclic esotropia is rare, with an estimated incidence of 1:3000 to 1:5000 strabismus cases. Congenital cases and several adult cases have been reported, but onset typically occurs during the preschool years. Fusion and binocular vision are usually absent or diminished on strabismic days, with marked improvement on days with aligned eyes. The response of cyclic esotropia to various forms of therapy, other than surgery, is unpredictable. Occlusion therapy has been shown to convert a cyclic deviation into a constant one.


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