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Changes in deviation following correction of hyperopia in children with fully refractive accommodative esotropia
K Watanabe-Numata1, S Hayasaka, K Watanabe
1Department of Ophthalmology, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Summary
Children with accommodative esotropia may develop consecutive exotropia. Amblyopia at initial diagnosis is a key risk factor for developing this deviation, impacting long-term eye alignment.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Accommodative esotropia is a common form of strabismus in young children.
- Correction of hyperopia with glasses is the standard treatment.
- Long-term changes in eye deviation can occur after initial treatment.
Purpose of the Study:
- To investigate factors influencing deviation changes in children treated for accommodative esotropia.
- To identify predictors for the development of consecutive exotropia.
Main Methods:
- Longitudinal study of 49 children diagnosed with accommodative esotropia at ages 3-4 years.
- All participants received glasses for refractive correction.
- Eye alignment, refractive error, and amblyopia were assessed at initial visit and ages 10-11 years.
Main Results:
- At 10-11 years, 57.1% had good alignment, 24.5% developed partial accommodative esotropia, and 18.4% developed consecutive exotropia.
- Initial amblyopia was significantly higher in the consecutive exotropia group (89%) compared to the good alignment group (50%).
- Age at onset, initial visit parameters (refraction, deviation, stereopsis), and age at correction were similar across groups.
Conclusions:
- Children with accommodative esotropia and initial amblyopia may be predisposed to developing consecutive exotropia.
- Amblyopia is a significant risk factor for developing divergent strabismus after initial treatment for accommodative esotropia.