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Related Experiment Video

Updated: Jun 12, 2026

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes
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Do bifocals reduce accommodative amplitude in convergence excess esotropia?

Michela Fresina1, Costantino Schiavi, Emilio C Campos

  • 1Ophthalmology Service, Department of Surgery and Anaesthesiology, University of Bologna, Bologna, Italy. michela.fresina@libero.it

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|June 5, 2010
PubMed
Summary

Bifocal lenses help children with accommodative esotropia by improving near point of accommodation (NPA). This treatment is crucial, even if surgery is considered, for managing convergence issues.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Vision Science

Background:

  • Accommodative esotropia can be linked to reduced near point of accommodation (NPA).
  • Bifocal lens therapy is a potential treatment for this condition.

Purpose of the Study:

  • To assess the effectiveness of bifocal lenses in children with non-refractive accommodative esotropia.
  • To evaluate changes in NPA after bifocal lens treatment.

Main Methods:

  • 28 children (ages 5-8) with accommodative esotropia and 28 controls were studied.
  • Near point of accommodation (NPA) was measured before bifocal prescription and after 4 years.
  • Patients had esotropia due to excess convergence for near vision.

Main Results:

  • Ten patients initially had below-average NPA (<10 diopters), which improved over 4 years but remained below 10 diopters.
  • One patient with initially normal NPA experienced a decrease, but values remained above 10 diopters.

Conclusions:

  • Excessive convergence in some patients stems from a primary NPA deficit.
  • NPA measurement aids in predicting prognosis for accommodative esotropia.
  • Bifocal lenses are essential for managing NPA deficits, even if strabismus surgery is performed.