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Is the maximum hypermetropic correction necessary in children with fully accommodative esotropia?
C J MacEwen1, E G Lymburn, W O Ho
1Department of Ophthalmology, Ninewells Hospital & Medical School, Dundee, UK. c.j.macewen@dundee.ac.uk
The British Journal of Ophthalmology
|April 15, 2008
Summary
Undercorrecting hypermetropic refractive error in children with fully accommodative esotropia worsens eye alignment. Providing the full prescription ensures better control of esotropia, supporting optimal visual development.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus
Background:
- Fully accommodative esotropia is a common form of strabismus in childhood.
- Accurate refractive correction is crucial for managing accommodative esotropia.
Purpose of the Study:
- To investigate the impact of reducing hypermetropic correction on the angle and control of fully accommodative esotropia.
- To determine the optimal level of hypermetropic correction for managing this condition.
Main Methods:
- A prospective study involving 30 children diagnosed with fully accommodative esotropia.
- Measurement of the angle of deviation with and without full hypermetropic correction at near and distance.
- Evaluation of the effect of reducing the correction by 1.00 and 2.00 diopters (DS) on deviation control.
Main Results:
- Full hypermetropic correction resulted in near deviation <10 prism diopters (pd) in 73% and distance deviation <10 pd in 93% of participants.
- Reducing correction by 1.00 DS decreased control, with near deviation <10 pd in 30% and distance <10 pd in 57%.
- Twenty percent of participants decompensated to manifest esotropia with a 1.00 DS reduction.
Conclusions:
- Children with fully accommodative esotropia benefit from full hypermetropic correction, achieving smaller and more controllable deviation angles.
- Undercorrection, even by 1.00 DS, significantly impairs deviation control.
- This study supports the clinical practice of prescribing the maximum tolerable hypermetropic correction for childhood esotropia.
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