Abstract：Objective: To describe the clinical characteristics of acute acquired comitant esotropia (AACE) and evaluate the effect of non-surgical treatment. Methods: Eighteen cases referred to General Hospital of the People's Liberation Army from August 2015 to November 2017 were reviewed. All participants underwent a complete medical history, ophthalmologic and orthoptic examinations, and brain and orbital imaging. The patients were followed up from 2 to 8 months, average 3.9 months. A paired t test was used for statistical analysis. Results: Age at onset was 29.7±10.3 years (21-52 years). All patients complained about uncrossed diplopia only at distance. The angle of esotropia at distance was from +9 to +60△ and was from +7 to +45△ at near (t=6.32, P<0.001). Each patient was examined by a neurologist, and MRI or CT imaging was performed. All the results were normal. After wearing a base-out Fresnel prism, 15 patients reported single vision with prismatic correction, 3 patients decided to undergo surgery after prismatic correction was unsuccessful. The angle of esotropia at distance was from +6 to +23△ and was from +4 to +18△ at near after prismatic correction. Eleven patients were satisfied, 4 patients were normal and 3 patients were dissatisfied. Conclusions: The clinical characteristics of AACE in our study were a sudden onset of nonaccommodative comitant esotropia with diplopia at distance. And happened in myopic patients, angle of esotropia at distance was larger than at near. Prismatic correction had good results on the improvement of diplopia and estropia. Long-term efficacy needs further observation.
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