A Case of Oculomotor Abnormalities in Congenital Esotropia

Lee, Young Chun; Koo, Tae Hyung

Abstract

Eye alignment is related with binocular connection in the visual cortex during critical period between postnatal 3 and 5 months. Authers examined horizontal pursuit and latent fixation nystagmus using electronystagmogram(ENG)in 6 year old female patient, who was diagnosed a congenital esotropia showing V patten esodeviation, both inferior oblique overaction, dissociated vertical deviation and head turn. In the pursuit examination, symmetric pursuit was observed under binocular viewing. However asymmetric pursuit was observed with smooth pursuit toward temporo-nasal direction and irregular saccade toward naso-temporal direction under monocular viewing. We could observe jerky nystagmus with decelerating velocity under monocular viewig, direction of which was toward fixating eye and degree of which was increased in abduction and decreased in adduction. The direction of pursuit asymmetry and nystagmus were instantaneously reversed when changing occluding eye. The results of ENG were not changed after successful strabismus surgery. We report a typical case of congenital esotropia as one of oculomotor disorders showing asymmetric pursuit and latent fixation nystagmus, which findings were proved by ENG.