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Refractive accommodative esotropia: a surgical problem?

G K von Noorden1, C W Avilla

  • 1Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

International Ophthalmology
|January 1, 1992
PubMed
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Refractive accommodative esotropia (RAET) patients rarely experience functional decline when treated with glasses. Studies show that A- and V-patterns and oblique muscle dysfunctions are often insignificant or absent when glasses are worn.

Area of Science:

  • Ophthalmology
  • Strabismus Research
  • Pediatric Eye Care

Background:

  • Refractive accommodative esotropia (RAET) is often treated surgically.
  • Commonly cited reasons for surgery include functional deterioration and cyclovertical strabismus or oblique muscle dysfunction.

Purpose of the Study:

  • To evaluate the necessity of surgical intervention for RAET.
  • To assess the long-term functional stability and prevalence of specific ocular muscle issues in RAET patients managed non-surgically.

Main Methods:

  • A retrospective analysis of 30 RAET patients treated with glasses over seven years.
  • A prospective study of 53 RAET patients evaluating A- and V-patterns and oblique muscle function with and without corrective lenses.

Main Results:

Related Experiment Videos

  • Only one of 30 RAET patients experienced functional deterioration over a seven-year follow-up with glasses.
  • Pseudo-A- and V-patterns were observed in RAET patients without glasses but resolved upon correction.
  • Oblique muscle dysfunctions were noted without glasses but were clinically insignificant.

Conclusions:

  • The data suggest that functional deterioration is infrequent in RAET patients managed with glasses.
  • The prevalence and clinical significance of A- and V-patterns and oblique muscle dysfunctions in RAET may be overestimated when patients are not wearing their corrective lenses.
  • Surgical intervention for RAET may not be as frequently indicated as previously thought, particularly when conservative management with glasses is effective.