In the practice of pediatric ophthalmology there is opportunity to accumulate a variety of ocular motility problems. One of the most unusual and intriguing to us is presented here.
Of approximately 3,500 squint cases reviewed, there are 3 that exhibit a unique quality—that of cyclic recurrence. These children all presented with esotropia which, on following its course, was found to be manifest only in regular cycles. The esotropia was not of paralytic nature during these times, and the squint was the only variable feature of the eye findings.
The literature is replete with discussion of natural cyclic occurrences and the "biological clock" as well as descriptions of many diseases with rhythmic recurrence. Reimann1,2 has found that about 200 periodic disorders have been described. Some of the newer ones are periodic fever, periodic myelodysplasia, periodic hypertension, and periodic pancreatosis.
Cyclic oculomotor paralysis, characterized by involuntary spastic contraction of the extraocular
COSTENBADER FD, MOUSEL DK. Cyclic Esotropia. Arch Ophthalmol. 1964;71(2):180-181. doi:10.1001/archopht.1964.00970010196007