Clinical Features of Refractive Accommodative Esotropia: Long-term Study

ABSTRACT

PURPOSE: To analyze the long-term clinical features and functional outcomes of refractive accommodative esotropia. METHODS: Initial and final age, cycloplegic refraction, distance and near deviation with and without correction, stereoacuity and incidence of amblyopia were evaluated in 45 patients with accommodative esotropia. RESULTS: The follow-up duration was 65.77+/-43.98 (6~151) months, and the mean age was 4.02+/-1.97 and 9.42+/-3.77 years at the first and final visits, respectively. The cycloplegic refraction was decreased from 5.16+/-1.92 diopters (D) to 4.41+/-1.83D, averaging -0.09+/-0.40D annually (P<0.01). Of these hyperopic eyes, 55 (61.1%) experienced a decrease, 22 (24.4%) an increase, and 5 (5.6%) showed no changes. From 5 (31.2%) to 12 (75.0%) of 16 patients had a stereoacuity of 100 sec/arc or better (p<0.01). Fusion was achieved in 14 (87.5%) at the final visit, up from 11 (68.8%) at the first visit (P=0.39); 23 (51.1%) of the patients were amblyopic; and anisometropia was found in 9 (39.1%) patients. CONCLUSIONS: Patients whose esotropia was corrected with full cycloplegic hyperopic correction show decreased longitudinal changes in spherical equivalent refractive error with a time course and have excellent binocularity outcomes.