Acute Acquired Comitant Esotropia and Digital Device Overuse in Children: a Three-Case Report

Manana Kikolashvili; Nino Nikuradze; Gigi Gorgadze

doi:10.52340/gs.2026.08.02.70

Authors

Manana Kikolashvili Tbilisi State Medical University https://orcid.org/0009-0008-4571-4222
Nino Nikuradze Tbilisi State Medical University https://orcid.org/0009-0006-1258-6514
Gigi Gorgadze Tbilisi State Medical University https://orcid.org/0000-0002-7885-639X

DOI:

https://doi.org/10.52340/gs.2026.08.02.70

Keywords:

Acute Acquired Comitant Esotropia (AACE), Digital Device Overuse, Pediatrics, Diplopia, Strabismus Surgery

Abstract

Acute acquired comitant esotropia (AACE) is an uncommon strabismus involving sudden-onset inward eye deviation and diplopia. Recent trends suggest a rising incidence among youth, potentially linked to excessive digital device use.

This study reviews three children (ages 8–12) who developed AACE and diplopia following prolonged daily screen time (≥4 hours). Clinical evaluations revealed full ocular motility and no neurological deficits, with deviations ranging from 24 to 50 prism diopters.

Management transitioned from conservative monitoring to surgery once deviations stabilized. Interventions included bilateral medial rectus recession or unilateral recession-resection.

Postoperatively, all patients achieved orthotropia, resolved diplopia, and restored normal stereopsis. While a temporal association exists between heavy digital use and AACE, causality remains unproven. However, surgical intervention remains highly effective for restoring binocular function. Further research is necessary to clarify the mechanisms behind this "digital-age" presentation of strabismus.

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Author Biography

Manana Kikolashvili, Tbilisi State Medical University

Zhvania Pediatric Academic Clinic of Tbilisi State Medical University, Tbilisi, Georgia

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