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Risk factors for accommodative esotropia among hypermetropic children
Eileen E Birch1, Sherry L Fawcett, Sarah E Morale
1Retina Foundation of the Southwest, Dallas, Texas 75231, USA. ebirch@retinafoundation.org
Investigative Ophthalmology & Visual Science
|January 27, 2005
Summary
Family history, poor stereo vision, and hyperopic anisometropia are key risk factors for accommodative esotropia in children. Identifying these can guide early intervention with glasses or therapy.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Genetics
Background:
- Accommodative esotropia is a common form of childhood strabismus.
- Early identification of risk factors is crucial for timely intervention.
- Hyperopia is a known risk factor, but specific predictive markers are needed.
Purpose of the Study:
- To identify risk factors for developing accommodative esotropia.
- To determine which children with hyperopia may benefit from early spectacle correction.
- To evaluate the role of family history, binocular sensory function, and refractive error in risk assessment.
Main Methods:
- Family history study: 95 children with accommodative esotropia.
- Binocular sensory function study: 41 children with recent-onset intermittent esotropia.
- Hypermetropia study: 345 children with hyperopia (+2.00 D or greater) and no early esotropia.
Main Results:
- 91% of children with accommodative esotropia had an affected relative.
- 41% showed abnormal random-dot stereoacuity.
- Hypermetropic anisometropia increased accommodative esotropia risk 7.8-fold.
Conclusions:
- Positive family history, subnormal stereopsis, and hypermetropic anisometropia are significant risk factors.
- These factors, combined with refractive screening, can identify children needing early intervention.
- Early spectacle correction or preventive therapy can be guided by these risk assessments.