EC Ophthalmology

Introduction: We report a case of acquired accommodative esotropia with binocular diplopia induced by high accommodative demand in the phakic eye following first cataract surgery.

Case Report: A 47-year-old female was referred for issues with on-going blurry vision, diplopia and strabismus following her first cataract surgery. The patient had a known diagnosis of diabetes mellitus type 2 and underwent her first cataract surgery to her left eye two years prior to this presentation. She was noted to have a cataract in her second eye and was waitlisted for right eye cataract surgery but unfortunately was lost to follow-up. Following a re-referral by her GP, the patient presented with a significantly large intermittent strabismus induced by high accommodative demand in her phakic eye which resulted in the development of a marked acquired accommodative esotropia with diplopia.

Conclusion: To our knowledge, there are few cases of acquired accommodative esotropia following cataract surgery reported in the literature. We aim to highlight the importance of ocular motility and binocular function assessments prior to cataract surgeries especially in younger age groups.

 Keywords: AC/A Ratio; Accommodation; Cataract; Diabetes; Diplopia; Esotropia; Strabismus

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