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Is hypermetropia regressing in accommodative esotropia?

Fatma Yulek1, Sema Yuzbasioglu1, Demet Eyidogan1

  • 1Ophthalmology Department, Ankara Atatürk Education and Research Hospital, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey.

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Summary

In accommodative esotropia, both hypermetropia and eye deviation decrease over time. However, refractive error changes do not always parallel the reduction in eye misalignment.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus Research

Background:

  • Accommodative esotropia is a common form of strabismus in children.
  • Hypermetropia plays a significant role in the development of accommodative esotropia.
  • Understanding the relationship between refractive error and ocular alignment is crucial for effective management.

Purpose of the Study:

  • To investigate the correlation between changes in hypermetropia and ocular alignment in patients with accommodative esotropia.
  • To analyze the rate of myopic shift and its impact on esotropic deviation.
  • To evaluate the long-term outcomes of refractive correction in managing accommodative esotropia.

Main Methods:

  • Retrospective review of medical records of patients diagnosed with refractive accommodative esotropia.
  • Analysis of cycloplegic refractions and spherical equivalents.
  • Evaluation of amblyopia, refractive error changes, and ocular alignment at admission and follow-up.

Main Results:

  • Seventy patients with a mean age of 6.01 years were included, with a mean follow-up of 5.8 years.
  • A gradual decrease in esotropic deviation and hypermetropia was observed during follow-up.
  • A weak correlation was found between the rate of myopic shift and the rate of change in corrected near deviation (r=0.18).

Conclusions:

  • Accommodative esotropia and associated hypermetropia tend to decrease over the follow-up period.
  • It is not advisable to guarantee patients that their eye deviation will decrease in direct proportion to refractive error changes.
  • Longitudinal studies are essential to fully understand the dynamic interplay between refractive error and ocular alignment in accommodative esotropia.