Alternate day esotropia.

A six-year-old girl was noted to develop alternate day esotropia three years following surgery for a moderate "v" esotropia. Many of the usual features of cyclic esotropia, including moderate hypermetropia, mild amblyopia, moderate to large deviation, a 48-hour cyclic pattern, and a high AC/C ratio were present. A therapeutic trial with strong miotics was unsuccessful. Saccadic velocity studies revealed no evidence of lateral rectus palsy. No fluctuations in pupillary size or response, refractive errors, accommodative amplitude, visual acuity, blood pressure, behavior, and the electroencephalographic pattern were noted. Following bimedial recession surgery, the eyes have remained straight and the cyclic pattern has been abolished for a two and one half year follow-up period. There is evidence to suggest that these patients are basically strabismic with cycles of remission.