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Early-onset refractive accommodative esotropia.

D K Coats1, C W Avilla, E A Paysse

  • 1Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|January 26, 2000
PubMed
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Early-onset refractive accommodative esotropia in infants, diagnosed as young as 4 months, showed no amblyopia and stable alignment with spectacles. Prematurity was identified as a significant risk factor in these young patients.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus

Background:

  • Investigating the natural history of pure refractive accommodative esotropia in infants with early onset (before 1 year old).
  • Comparing outcomes and characteristics with patients experiencing typical onset of refractive accommodative esotropia.

Purpose of the Study:

  • To determine if early-onset refractive accommodative esotropia (before 1 year) differs in outcomes and characteristics from later-onset cases.
  • To identify risk factors and long-term prognosis for infantile refractive accommodative esotropia.

Main Methods:

  • Retrospective chart review of 17 children with refractive accommodative esotropia onset before 1 year.
  • Comparison with a control group of 26 children with onset after 2 years.
  • Analysis of diagnostic age, alignment with spectacles, need for surgery, amblyopia development, and prematurity.

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Main Results:

  • Mean age at diagnosis was 9 months for early-onset vs. 48 months for controls.
  • No amblyopia developed in the early-onset group, compared to 42% in controls (P=.001).
  • Prematurity was a significant risk factor for early-onset esotropia (47% vs. 12%, P=.03).

Conclusions:

  • Refractive accommodative esotropia can be diagnosed as early as 4 months.
  • Full hyperopic spectacle correction provides long-term stable alignment with a low need for surgery in early-onset cases.
  • Prematurity is a notable risk factor for this condition.