Incidence and Types of Childhood Esotropia. A Population-Based Study

Objective: To describe the incidence and types of childhood esotropia in a defined population. Design: Retrospective population-based cohort. Participants: All pediatric (<19 years of age) residents of Olmsted County, Minnesota, diagnosed with an esodeviation (≥10 prism diopters) from January 1, 1985, through December 31, 1994. Methods: The medical records of all potential patients identified by the resources of the Rochester Epidemiology Project were reviewed. Main Outcome Measures: Incidence and types of childhood esotropia. Results: Three hundred eighty-five cases of childhood esotropia were identified during the 10-year period, yielding an annual age- and gender-adjusted incidence of 111.0 (95% confidence interval, 99.9-122.1) per 100 000 patients younger than 19 years of age. This rate corresponds to a cumulative prevalence of approximately 2.0% of all children younger than 6 years, with a significant decrease in older ages (P<0.0001). Of the 385 study children, the specific forms and percentages of esotropia diagnosed were as follows: fully accommodative, 140 (36.4%); acquired nonaccommodative, 64 (16.6%); esotropia associated with an abnormal central nervous system, 44 (11.4%); partially accommodative, 39 (10.1%); congenital, 31 (8.1%); sensory, 25 (6.5%); paralytic, 25 (6.5%); undetermined, 13 (3.4%); and other, 4 (1.0%). Conclusions: The incidence of childhood esotropia from this self-referred population-based study is comparable with prevalence rates reported among Western populations. Esotropia is most common during the first decade of life, with the accommodative and acquired nonaccommodative forms occurring most frequently. The congenital, sensory, and paralytic forms of childhood esotropia were less common in this population.