The Factors Influencing the Visual Acuity and Streoacuity Outcome in Refractive Accommodative Esotropia

ABSTRACT

PURPOSE: To evaluate the factors affecting the visual acuity and stereoacuity of patients with refractive accommodative esotropia who have successful optical alignment obtained by refractive error management. METHODS: The charts of 60 patients, including medical history, age of onset, chief complaint at first visit, age at which glasses were first worn, refractive error, visual acuities with and without glasses, angle of deviation, and stereoacuity were retrospectively reviewed. RESULTS: The mean follow-up period was 59.20 +/- 40.26 months, and the mean hypermetropia at the initial visit was 4.90 +/- 1.75 diopters (D). Fifty-three patients had decreased hypermetropia, with a mean of 0.94 +/- 0.91 D, while seven patients had increased hypermetropia, with a mean of 0.38 +/- 0.17 D. The mean deviation at the initial visit was 28.40 +/- 9.05 prism diopters (PD) at near without glasses and decreased to 3.20 +/- 3.50 PD with glasses at the final visit. Children who had anisometropia at the initial visit had a higher prevalence for amblyopia at the final visit (p = 0.000). However, the degree of hypermetropia, age at onset, deviation before glasses correction, interval from onset to glasses correction, and amblyopia at diagnosis were not significant risk factors for amblyopia or anomalous streoacuity at the final visit. CONCLUSIONS: The degree of hypermetropia, age at onset, deviation before glasses correction, interval from onset to glasses correction, and amblyopia at diagnosis were not significant risk factors for amblyopia. However, anisometropia was a significant risk factor for the development of amblyopia in patients with refractive accommodative esotropia, and these children should receive careful and long-term follow-up management.