ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Binasal occlusion for the non-invasive management of acute acquired comitant esotropia
Provisionally accepted
- First Hospital, Peking University, Beijing, China
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Purpose:To assess the clinical effectiveness of binasal occlusion (BNO) as a non-invasive treatment for acute acquired comitant esotropia (AACE) and to explore potential predictors of therapeutic response. Methods:This retrospective case series included 32 AACE patients who underwent BNO therapy for at least six months. Changes in ocular deviation angles, diplopia resolution, and binocular function were assessed before and after treatment. Patients were categorized into cured (orthophoria), effective (≥ 10 prism diopter [PD] reduction), and ineffective groups. Univariate and multivariate analyses were conducted to identify predictors of therapeutic success. Results:BNO significantly reduced ocular deviation. The median near deviation decreased from 25.00 PD (IQR 20.00–30.00) to 17.50 PD (IQR 5.50–33.75) (P = 0.002), and the median distance deviation decreased from 30.00 PD (IQR 21.25– 40.00) to 20.00 PD (IQR 5.25–35.00) (P < 0.001). Diplopia resolved in 50% of patients (P < 0.001), and fusion function improved significantly (P = 0.019). Smaller initial deviations and shorter disease duration were associated with favorable outcomes in univariate analysis but did not emerge as independent predictors in multivariate analysis, suggesting a potential synergistic interaction. Conclusion:BNO represents a promising, non-invasive intervention for AACE, particularly in cases with smaller deviations and early presentation. This case series provides preliminary evidence that BNO may reduce deviation and potentially lower surgical need. However, the absence of a control group precludes causal inference. Future randomized controlled trials with standardized outcomes are needed to confirm efficacy and define BNO's role in AACE management.
Keywords: Acute acquired comitant esotropia, Binasal Occlusion, binocular vision, Conservative therapy, Diplopia
Received: 09 Nov 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Li, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ruiying Li
Xiaoqing Li
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