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Ultranear testing in accommodative esotropia
Purpose:
To determine if patients with accommodative esotropia controlled with glasses maintain ocular alignment at viewing distances less than 1/3 m.
Design:
Prospective case-control study.
Methods:
Thirty children with refractive-type accommodative esotropia were evaluated for ocular alignment at 6 m, 1/3 m, and 1/6 m ("ultranear") using accommodative targets. Ten children without strabismus served as controls.
Results:
Twenty-eight of 30 (93%) of children with otherwise controlled accommodative esotropia exhibited a manifest deviation of 5(Δ) to 16(Δ) when measured at ultranear. Excessive accommodation appeared to be present in at least some accommodative esotropes. Regardless of viewing distance, esophoria or esotropia was not elicited in control patients (P <0.0001).
Conclusion:
Children with refractive accommodation esotropia demonstrate excess convergence at very close testing distances. Excess accommodation may partly explain this observation.
