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The effect of reducing hyperopic correction in patients with accommodative esotropia
1Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Summary
Undercorrecting hyperopic refractive error in accommodative esotropia patients maintained stable visual acuity and eye alignment for two years. This approach proved safe and effective for managing this condition without negative impacts.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Optometry
Background:
- Accommodative esotropia is a common form of strabismus in children.
- Hyperopic refractive error is a significant contributing factor.
- Current management often involves full refractive correction.
Purpose of the Study:
- To evaluate the long-term effects of spectacle undercorrection in patients with accommodative esotropia.
- To assess the stability of visual acuity, eye alignment, and binocular function over a 2-year period.
Main Methods:
- A prospective study involving 39 patients with refractive accommodative esotropia.
- Patients received maximal tolerable spectacle undercorrection (up to -1.5 D).
- Follow-up included assessments of visual acuity, angle of deviation, stereoacuity, and fusional ability at 2 years.
Main Results:
- No significant deterioration in visual acuity, angle of deviation, stereoacuity, or fusional ability was observed in any patient.
- Minor changes in the angle of deviation (2-4 prism diopters) were noted in only 3 patients.
- The undercorrection strategy was well-tolerated, with no adverse effects reported.
Conclusions:
- Spectacle undercorrection of hyperopic refractive error is a safe and effective strategy for managing accommodative esotropia.
- This approach leads to stable eye alignment and preserved binocular function over a 2-year follow-up.
- Further research may explore long-term outcomes and optimal undercorrection levels.
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