Do All Children With Acute Comitant Esotropia Require Neuroimaging?

In this interview from AAO 2019, Dr. Jane Edmond discusses when neuroimaging should be considered in children with acute acquired comitant esotropia (AACE). To tease out benign from more serious intracranial conditions, she recommends taking a careful history and performing a thorough examination. For example, the combination of AACE with a tussive or Valsalva headache is suggestive of Chiari type I. Headaches at night or upon awakening could indicate elevated intracranial pressure and hydrocephalus. For AACE patients without concerning symptoms, however, she recommends monthly follow-ups and to keep a look out for any new symptoms that would prompt neuroimaging.  

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