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Acquired esotropia: subjective and objective outcomes
P A Costello1, J W Simon, Y Jia
1Department of Ophthalmology, Albany Medical College, New York, USA.
Insights
Treatment for acquired esotropia in children is highly effective and cost-efficient. This pediatric therapy significantly improves eye alignment and is deemed crucial by parents for their child
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Health Services Research
Background:
- Third-party payers increasingly require outcome data for pediatric therapy resource allocation.
- Acquired esotropia in children necessitates effective treatment strategies.
- Assessing treatment effectiveness involves both objective clinical measures and subjective parental reports.
Purpose of the Study:
- To evaluate the effectiveness of treatments for acquired esotropia in pediatric patients.
- To compare objective clinical outcomes with subjective parental assessments of treatment impact.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with acquired esotropia after their first birthday (1994-1995).
- Objective clinical data collection including esotropic angles at distance and near.
- Telephone questionnaire to gather parents' subjective impressions of treatment quality and impact.
Main Results:
- Significant reduction in mean esotropic angles: from 33.1 to 4.9 PD at distance and 40.0 to 11.4 PD at near, following treatment with glasses and/or surgery.
- Effective treatment achieved in 81% of cases among the 26 patients with amblyopia.
- Parents overwhelmingly considered treatment 'extremely important' (90%) for their child's future well-being.
Conclusions:
- Treatment for acquired esotropia in childhood is demonstrably effective, yielding significant objective improvements in eye alignment.
- Subjective parental reports confirm the high value and importance placed on successful treatment outcomes.
- The therapeutic approach is relatively inexpensive, offering a cost-effective solution for a common pediatric condition.
Purpose:
The measurement of outcomes of pediatric therapy will be increasingly important to third-party payers as they allocate health care resources. We undertook this study to assess the effectiveness of treatment of acquired esotropia, as measured subjectively by parents and objectively by examination.
Methods:
A chart review was used to gather objective clinical data from all patients presenting between 1994 and 1995 with esotropia after their first birthday. Parents' impressions of the quality and impact of treatment were tabulated by using a telephone questionnaire.
Results:
Of 48 patients studied (mean age, 3.8 years; 44 months' follow-up), the 26 with amblyopia were effectively treated in 81% of cases. Mean esotropic angles decreased, with glasses and/or surgery, from 33.1 to 4.9 PD at distance and from 40.0 to 11.4 PD at near. The average estimated cost of care was 547 dollars per patient per year. Parents considered treatment "extremely important" to their child's future happiness and success in 90% of cases.
Conclusion:
Our experience has shown that treatment of acquired esotropia in childhood, while relatively inexpensive, is highly effective, both objectively and subjectively.
