Type III acute acquired comitant esotropia (AACE) is a special type of binocular coordination disorder with sudden onset characteristics, but its pathogenesis and treatment strategies remain unclear. This article analyzes the incidence and classification characteristics of Type III AACE, and explores its pathogenesis from multiple perspectives including clinical medicine, neuroscience, and neuro-ophthalmology. It is found that this disease is associated with factors such as decompensation of phoria, dysfunction of the visual center, abnormalities in the physiological and anatomical structure of extraocular muscles, accommodative factors, and disorders of convergence and divergence. The prognosis of Type III AACE is excellent with treatments such as botulinum toxin injection and surgery, and adjunctive therapies like prism adaptation test and visual function training can enhance the management effect. This article provides an in-depth analysis of the pathogenesis and cutting-edge treatment techniques for patients with Type III AACE, which can offer guidance for the subsequent diagnosis and treatment of such patients.