Abstract
PURPOSE: This study aimed to examine the clinical characteristics and quality of life of adult patients with acute acquired comitant esotropia (AACE) in China and to identify factors associated with patients’ quality of life. METHODS: This study employed a cross-sectional survey design. The case group comprised 50 patients diagnosed with AACE, whereas the strabismus control group consisted of 47 patients with other forms of strabismus. Additionally, 54 individuals with normal eye positions were included in the control group. The Chinese version of the Adult Strabismus Quality of Life Scale (CAS-20) was utilized to evaluate the quality of life of all participants. Concurrently, individual variables were documented. Statistical analyses were performed to compare the clinical attributes and quality of life scores across the three groups, and an analysis was conducted to determine the influence of various factors on the quality of life of AACE patients. RESULTS: The disease duration in the AACE group was significantly shorter than that in the other strabismus group (p < 0.001). Both the near and distance stereopsis proportions were significantly lower in both the AACE group and the other strabismus group than in the normal group (p < 0.001). Additionally, the time spent on near-vision tasks was significantly greater in the AACE group than in the other two groups (p < 0.001). The total scores for social psychology and visual function were lower in both the AACE group and the other strabismus group than in the normal control group (p < 0.001). However, the total score for social psychology was higher in the AACE group than in the other strabismus group (p < 0.001). Among AACE patients, the total scores for social psychology and visual function were higher in the distance stereopsis function group than in the non-distance stereopsis function group (p < 0.05) and higher in the near stereopsis group than in the non-near stereopsis group (p < 0.001). CONCLUSION: Prolonged use of close-up eye activities poses a risk for AACE in susceptible populations. Patients with adult AACE in China typically exhibit a short disease duration. The quality of life of these patients is significantly deteriorated, primarily due to factors such as loss of stereopsis, an increased degree of strabismus, and extended disease duration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-025-04597-5.