Progressive-Addition Lenses for Accommodative Esotropia with a High Accomodative Element

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Vision Science

Background:

• Accommodative esotropia with a significant accommodative component is traditionally managed with bifocal lenses.
• Progressive-addition lenses (PAL) offer an alternative treatment approach.

Purpose of the Study:

• To evaluate the age-dependent effectiveness of PAL in managing accommodative esotropia with a high accommodative element.
• To assess improvements in both motor (deviation) and sensory (stereopsis) performance.

Main Methods:

• A retrospective study of 32 patients without eye muscle surgery was conducted.
• Two subgroups were analyzed: those treated solely with PAL (n=7) and those initially treated with bifocals then switched to PAL (n=25).
• Motor deviation was measured using the alternate prism cover test, and stereoacuity was assessed with the Stereo fly and Randot stereo tests.

Main Results:

• Near deviation decreased from an average of 28 prism diopters (PD) to 0 PD with PAL correction in the PAL-only group.
• Stereopsis improved significantly in both groups: from 113" to 54" in the PAL-first group and from 541" to 141" in the bifocal-first group.

Conclusions:

• PAL treatment demonstrates efficacy in achieving favorable sensory and motor outcomes for accommodative esotropia with a high accommodative element.
• Both PAL and bifocal lenses were found to be equally beneficial as initial treatments for young children diagnosed with convergence excess esotropia.