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Brodsky MC. An Expanded View of Infantile Esotropia: Bottoms Up! Arch Ophthalmol. 2012;130(9):1199–1202. doi:10.1001/archophthalmol.2012.2067
Author Affiliations: Departments of Ophthalmology and Neurology, Mayo Clinic, Rochester, Minnesota.
A recent editorial in the Archives assigned the primary pathogenesis of infantile esotropia to the visual cortex. This analysis addresses the limitations of this timeworn view and advances the perspective that infantile esotropia is a cortico-mesencephalic-cerebellar disorder wherein binocular cortical maldevelopment permits atavistic subcortical visual pathways to remain operational. This integrated neuroanatomical model predicts that primary neurodevelopmental disorders involving the accessory optic system or its connections to the cerebellum can also give rise to infantile esotropia.
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