A child presents with an esotropia measuring 45 prism dioptres at distance and 20 prism dioptres at near. The near-distance disparity suggests which type?
- A Fully accommodative esotropia
- B Non-accommodative convergence excess
- C Divergence insufficiency ✓
- D Congenital (infantile) esotropia
Correct answer: C. Divergence insufficiency
Explanation
Divergence insufficiency is characterised by greater esotropia at distance compared to near (distance > near), as the divergence mechanism is deficient for distance fixation but convergence (near) is relatively preserved. Non-accommodative convergence excess shows greater esotropia at near than at distance (near > distance). Fully accommodative esotropia typically has similar measurements at near and distance when wearing the full cycloplegic correction. Congenital esotropia is large-angle constant and usually equal at near and distance.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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