Which statement describes a finding most consistent with a micro ET when considering suppression and test findings?

• A. Large, obvious suppressions using standard tests
• B. Small central suppression scotoma detected by four base-out prism test
• C. No suppression with any test
• D. Constant, large-angle deviation in all gaze positions

Answer: (B)

Micro esotropia presents with a very small inward deviation, so the sensory system often uses only a tiny amount of suppression to avoid diplopia. That suppression is typically central, affecting a very small area around the fovea. Many standard tests that dissociate the eyes broadly can miss this subtle suppression or show it only as a vague finding, but a targeted dissociating test like the four base-out prism test is designed to reveal small central suppression the moment the eyes are dissociated just enough. Seeing a small central suppression scotoma with this test is therefore highly consistent with a micro esotropia pattern, because it reflects the minimal yet real suppression that accompanies a tiny misalignment.

In contrast, large, obvious suppressions on standard tests would suggest a bigger deviation or a more pronounced suppression mechanism; no suppression across tests would be unlikely if there is an eye misalignment; and a constant, large-angle deviation in all gaze positions points to a macro (larger) esotropia rather than a micro one.