This clinical case report documents the diagnostic workup and successful non-invasive management of a 92-year-old female presenting with Age-Related Distance Esotropia (ARDE), also known as Sagging Eye Syndrome. The patient, who has comorbidities of Parkinson’s disease and Type 2 Diabetes, exhibited a pathognomonic distance-near disparity (12 ∆ esotropia at distance vs. 7 ∆ exotropia at near). Clinical evaluation via Hess-Lancaster screening and prism titration (Schober Test) led to the successful implementation of a 4 ∆ Base-Out prism correction. The case emphasizes the effectiveness of conservative optical rehabilitation in restoring binocular fusion and quality of life in the fragile geriatric population.
Fatim Zahra Hakki El Haouassi (2026) studied this question.