Divergence insufficiency is an acquired condition that is characterized by a concomitant esodeviation that is at least 10 prism diopters (PD) greater at distance than near. It was originally classified by Duane in 1896 as part of his system to categorize horizontal strabismus. Parinaud was the first to describe divergence paralysis, which is characterized by an esotropia that is greater at distance, complete absence of divergence, and associated neuroanatomic pathology. Previous studies have used various systems to classify divergence insufficiency-type esotropia.
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