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Changes in refractive error in patients with accommodative esotropia after being weaned from hyperopic correction.

Yoonae A Cho1, Won Yeol Ryu2

  • 1Nune Eye Hospital, Seoul, Republic of Korea Strabismus Center of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.

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Summary

Early emmetropisation in accommodative esotropia (AET) can lead to myopia development and worsening ocular alignment. Careful monitoring is essential for these patients after discontinuing glasses.

Keywords:
Treatment Medical

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Refractive Error Research

Background:

  • Accommodative esotropia (AET) is a common condition in children.
  • Emmetropisation, the process of refractive development towards emmetropia, can impact AET management.
  • Discontinuing hyperopic glasses in AET patients who achieve emmetropisation requires long-term follow-up.

Purpose of the Study:

  • To investigate long-term changes in refractive error and ocular alignment in patients with AET.
  • To assess outcomes after discontinuing hyperopic glasses due to successful emmetropisation.
  • To identify potential risk factors for refractive and alignment changes.

Main Methods:

  • Study included 47 patients with refractive AET who achieved emmetropisation and orthotropia without hyperopic glasses.
  • Patients were followed for at least 3 years after discontinuing glasses.
  • Refractive error (spherical equivalent) and ocular alignment (esotropia/exotropia) were analyzed.

Main Results:

  • Mean follow-up was 5.7 years.
  • 55.3% of patients developed myopia, with a mean progression rate of -0.19 D/year.
  • 87.2% maintained orthotropia, but 6.4% developed esotropia and 6.4% developed exotropia, all associated with myopia.

Conclusions:

  • Early emmetropisation in AET patients necessitates monitoring for myopia development.
  • Deterioration of ocular alignment can occur even after successful emmetropisation and glasses cessation.
  • Initial hyperopia and high AC/A ratio may correlate with later refractive errors.