Refractive Accommodative Esotropia: Duration between Wearing Hyperopic Glasses and Control of Esotropia within 8 PD

PURPOSE: To report clinical aspects of children diagnosed with refractive accommodative esotropia after wearing their first glasses to correct hyperopia accompanied with esodeviation. METHODS: The present study included 75 children followed up for at least 24 months. Age, spherical equivalent of refractive error, angle of deviation and presence of amblyopia were analyzed according to the duration between first wearing glasses and control of esotropia within 8 PD (2 months). RESULTS: The mean age was 4.48 +/- 2.08 years and mean follow-up was 50.17 months. Initial deviation angle without glasses was 25.43 +/- 10.07 PD at far, 27.72 +/- 11.45 PD at near, spherical equivalent was +4.86 +/- 2.41 D in right eyes, +5.05 +/- 1.06 D in left eyes and 8 of 75 patients (10.67%) had 2 months had less hyperopia (+4.02 D vs. 5.17 D), more severe esodeviation both at far (30.79 +/- 10.79 PD vs. 24.17 +/- 9.56 PD, p = 0.03) and at near distance (34.00 +/- 14.20 PD vs. 26.25 +/- 10.31 PD, p = 0.02) and higher initial amblyopia prevalence rates (71.5% vs. 47.5%). CONCLUSIONS: Several patients needed longer follow-up until esotropia was controlled within 8 PD after wearing hyperopic glasses considering the amount of hyperopia and angle of esodeviation.

Clinical Manifestation of Patients with Accommodative Esotropia for 10 Years

PURPOSE: To analyze the clinical features of patients who successfully discontinued correction with hyperopic glasses for refractive accommodative esotropia during a 10 year follow-up. METHODS: The authors of the present study analyzed 29 patients followed-up for a minimum of 10 years after diagnosis of accommodative esotropia. The patients were divided into 2 groups: patients who successfully discontinued correction with hyperopic glasses (10 patients, Group A), and patients who required constant use of hyperopic glasses (19 patients, Group B). The age at first visit, refractive error, deviated angle without correction, stereopsis, and follow-up duration were compared between the 2 groups. RESULTS: The mean age at first visit for all patients was 3.03 +/- 1.46 years, and the follow-up duration was 11.3 +/- 1.51 years. Patients in Group A discontinued the use of hyperopic glasses after 10.26 +/- 2.08 years. There were no statistical differences in mean age at first visit, deviated angle without correction, stereopsis, follow-up duration, or the amount of change in hyperopia. The initial amount of hyperopia in Group A was 3.81 +/- 1.54 D, significantly lower than the 5.12 +/- 1.37 D in Group B. CONCLUSIONS: After a 10 year follow-up of accommodative esotropia, 34% of the patients discontinued the use of hyperopic glasses, and the hyperopic amount at initial visit was statistically lower than that of patients who required constant use of hyperopic glasses.