Long-term treatment results of accommodative esotropia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus

Background:

• Accommodative esotropia is a common form of strabismus in children.
• Early diagnosis and management are crucial for visual development.
• Long-term outcomes of refractive accommodative esotropia require further investigation.

Purpose of the Study:

• To evaluate the long-term ocular alignment outcomes in patients diagnosed with refractive accommodative esotropia.
• To identify factors influencing the development of persistent or recurrent strabismus after initial treatment.

Main Methods:

• Retrospective review of medical records for patients aged ≤12 years with refractive accommodative esotropia.
• Inclusion criteria required follow-up of at least 10 years after spectacle correction.
• Ocular alignment was assessed at multiple time points, with a focus on outcomes 10 years post-correction.

Main Results:

• 107 patients were analyzed with a mean follow-up of 12 years.
• 79% achieved orthophoria or minimal esotropia (≤10 prism diopters) at distance and near fixation 10 years after correction.
• 13% developed consecutive exotropia, 5% experienced decompensation, and 3% had high accommodative convergence/accommodation (AC/A) ratio esotropia.

Conclusions:

• Spectacle treatment for refractive accommodative esotropia generally leads to favorable long-term ocular alignment.
• A subset of patients may develop consecutive exotropia or other forms of esotropia.
• Factors like time to correction, initial refraction, and amblyopia did not predict these long-term deviations.