Follow-up of nonrefractive accommodative esotropia with myopia 22 years

Purpose: To determine the efficacy of all time wear of full cycloplegic correction in the management of refractiveaccommodative esotropia. Design: Descriptive study using non-probability purposive sampling technique. Setting: Ophthalmology OPDand Department of Nishtar Hospital, Multan. Period: Oct 2009 to Sep 2010. Material and Methods: All children with accommodativeesotropia associated with hyperopia were included in the study. The features studied were ocular alignment, association of anisometropiawith strabismus and amblyopia, improvement in deviation of squint after amblyopia therapy and full cycloplegic hyperopic correctionand regain of binocular single vision and requirement for surgery in patients with accommodative esotropia with hyperopia. Results:Forty four children with refractive accommodative esotropia were identified. Cycloplegic refraction was done for all patients and fullcycloplegic correction was given. At presentation 36.4% of children were amblyopic in either eye and most of them had anisometropichypermetropia. The esotropia was present in more hypermetropic eye. 63.6% of the patients became straight with glasses only andanother 25% became straight after amblyopia therapy. Fusion with gross stereopsis was demonstrated in 75% of patients. Cycloplegicrefraction remained stable throughout the follow up period. None of these patients was able to discontinue glasses and maintainalignment. Surgery was required in only 11.4% of total patients. Conclusions: Most children with refractive accommodative esotropiahave an excellent outcome in term of visual acuity, ocular alignment and binocular single vision with the glasses. Full cycloplegiccorrection and amblyopia therapy resulted in marked reduction in the deviation of squint and improvement in visual acuity of theamblyopic eye as compared with the prevalence at presentation. The degree of hyperopia remains unchanged with poor prospect fordiscontinuing glasses wear.

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Accommodative Esotropia Long Range Follow-up

Ophthalmology ◽

10.1016/s0161-6420(83)34415-8 ◽

1983 ◽

Vol 90 (10) ◽

pp. 1141-1145 ◽

Cited By ~ 65

Author(s):

Kenneth C. Swan

Keyword(s):

Long Range ◽

Accommodative Esotropia

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Long-term Follow-up of Refractive Accommodative Esotropia

Strabismus and Ocular Motility Disorders ◽

10.1007/978-1-349-11188-6_43 ◽

1990 ◽

pp. 315-318 ◽

Cited By ~ 1

Author(s):

Nobue Kubota ◽

Shiro Akatsu

Keyword(s):

Long Term Follow Up ◽

Accommodative Esotropia

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Outcome of surgery for near angle in patient with incomitant distance/near esotropia and without manifest deviation at distance

European Journal of Ophthalmology ◽

10.1177/1120672120964697 ◽

2020 ◽

pp. 112067212096469

Author(s):

Matteo Scaramuzzi ◽

Massimiliano Serafino ◽

Paolo Nucci

Keyword(s):

Surgical Approach ◽

Significant Difference ◽

Consecutive Exotropia ◽

Full Correction ◽

Refractive Correction ◽

Accommodative Esotropia ◽

Outcome Of Surgery ◽

Cover Test

Introduction: To investigate how a subset of patients with partially accommodative esotropia, with a manifest deviation <10 Prism Diopters (PD) at distance and an angle of strabismus at near wider than 10 PD, could respond to a surgical approach based on the misalignment at near. Methods: Six patients examined from 2015 to 2019 met criteria for inclusion: partially accommodative esotropia, patients compliant to full correction for at least 6 months, angle of esotropia for near larger at least 10 PD, angle of misalignment obtained with the alternate prism cover test and simultaneous prism cover test at distance <10 PD. All patients underwent bilateral medial recti recession. They were examined at 3 weeks and at 6 months. Results: No significant difference in the angle of esotropia at distance was found at any follow-up (Baseline: 7.17 ± 1.33 PD vs 3 weeks: 7.0 ± 1.01 PD vs 6 months: 7.33 ± 1.03 PD, p = 0.65, and p = 0.36, respectively). No case of consecutive exotropia was described. Considering the angle at near, there was a significant reduction at 3 weeks (Baseline: 41.7 ± 6.83 PD vs 3 weeks: 9.33 ± 1.63 PD, p = 0.027), that remained stable at the final follow-up (9.0 ± 1.1 PD, p = 0.32). All patients were suppressors and had nil stereopsis pre-operatively, all of them developed fusion and a different degree of stereopsis [276 ± 284 arcseconds (Range 80–800)]. Conclusions: A surgical approach based on the angle of strabismus for near could obtain satisfactory ocular alignment without consecutive exotropia in children with partially accommodative esotropia wearing full refractive correction, with a manifest deviation for distance <10 PD and a higher misalignment for near, at least for 6 months after surgery.

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