Accommodative esotropia who needs spectacles for good ocular alignment after refractive shift below +2.00 diopters

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus

Background:

• Refractive accommodative esotropia (RAE) is a common form of strabismus in children.
• While spectacle correction is the primary treatment, some patients continue to require glasses even after refractive error reduction.

Purpose of the Study:

• To investigate the clinical characteristics of RAE patients whose refractive errors improved but still needed spectacles.
• To identify factors associated with the need for continued spectacle wear in RAE.

Main Methods:

• Retrospective review of 92 RAE patients (1995-2011) with initial hyperopia ≥+2.00 D, reduced to <+2.00 D.
• Patients were grouped based on ocular alignment at the last visit (persistent esotropia vs. good alignment).
• Analysis included refractive error, stereotesting (Lang I, Stereo Fly), and duration to spectacle prescription.

Main Results:

• No significant difference in refractive error changes between groups.
• Significantly poorer performance on Lang I and Stereo Fly stereotests in patients with persistent esotropia.
• Stereotesting results and time to spectacle prescription were associated with continued spectacle need.

Conclusions:

• Stereoacuity is a more significant factor than refractive error in RAE patients requiring ongoing spectacle wear.
• Prompt treatment of RAE at onset is important for potential discontinuation of spectacles.