Long-term treatment results of accommodative esotropia

J AAPOS. 2014 Jun;18(3):261-5. doi: 10.1016/j.jaapos.2014.01.018.


Purpose: To report the long-term ocular alignment outcomes of patients with accommodative esotropia.

Methods: The medical records of consecutive patients ≤12 year of age diagnosed with refractive accommodative esotropia (esotropia eliminated or decreased to within 10(Δ) with full hyperopic correction) and followed for at least 10 years were retrospectively reviewed.

Results: A total of 107 patients were included (mean age, 4.81 ± 2.64 years). The mean follow-up period was 12.02 ± 2.25 years (range, 10-21 years). At the first examination performed 10 years after spectacle correction (mean, 10.2 years), 85 patients (79%) had orthophoria or esotropia ≤10(Δ) at both near and distance fixation, 14 (13%) had consecutive exotropia, 5 (5%) had decompensation and 3 (3%) had esotropia with a high ratio of accommodative convergence to accommodation (AC/A). The mean time interval between presentation and prescription of full hyperopic correction, initial cycloplegic refraction, and presence of amblyopia was not associated with consecutive exotropia, decompensation, or a high AC/A ratio esotropia.

Conclusions: Whereas most patients with refractive accommodative esotropia maintained normal long-term ocular motility with spectacle treatment, some developed consecutive exotropia, nonaccommodative esotropia, or esotropia with a high AC/A ratio.

MeSH terms

  • Accommodation, Ocular*
  • Child
  • Child, Preschool
  • Esotropia / physiopathology
  • Esotropia / therapy*
  • Eyeglasses*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Vision, Binocular / physiology
  • Visual Acuity / physiology