Unhealthy Overuse of Electronic Devices is a Risk Factor for Acute Acquired Concomitant Esotropia: A Case-Control Study

To investigate the key features of electronic device use in the AACE (acute acquired concomitant esotropia) population and compare them with those in normal and other strabismus populations, while further exploring the pathogenesis of AACE.
A case-control study was conducted on patients admitted to the strabismus department of our hospital from March 2023 to March 2024. The cohort comprised 48 acute acquired concomitant esotropia (AACE) patients, 55 intermittent exotropia (IXT) patients, and 48 healthy controls. Their refractive status and strabismus histories were documented. Additionally, a multiple logistic regression analysis was performed using a questionnaire on electronic device usage to identify the risk factors for AACE.
Regardless of adjustments, patients in the AACE group used digital devices for 7.74 ± 4.33 hours per day, significantly longer than those in the IXT and normal groups (p < 0.001). Multivariate logistic regression analysis revealed that long-term use of electronic devices was a risk factor for AACE (OR, 1.28; 95% CI, 1.09,1.49; p < 0.001). Among the 48 patients with AACE, 29 (63.04%) engaged in near-vision tasks without refractive correction, which was significantly higher than in the other two groups, and the difference was statistically significant (p = 0.005).
Prolonged and excessive use of electronics serves as a risk factor for acute acquired concomitant esotropia. This finding provides valuable information for clinicians on how to prevent AACE in daily life, such as minimizing electronic device use and wearing prescription glasses when engaging in near-vision tasks.