Characteristics of Esodeviation Related to Hyperopia in Children Aged 4 to 6 Years: A Retrospective Cohort Study

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Research

Background:

• Accommodative esotropia is a common form of strabismus in children.
• Hyperopia is frequently associated with esotropia, influencing treatment strategies.
• Understanding predictive factors for treatment success is crucial for managing pediatric esotropia.

Purpose of the Study:

• To investigate the characteristics of esotropia combined with hyperopia in children aged 4 to 6 years.
• To identify factors predicting the response to glasses in this patient population.

Main Methods:

• Retrospective review of 142 pediatric patients (4-6 years old) with esotropia and hyperopia (≥1.5D).
• Classification into four groups based on response to correction: fully corrected (FCAET), residual esotropia ≤8Δ (AET), residual esotropia ≥10Δ (PAET), and non-responders (NAET).
• Analysis of best-corrected visual acuity, angle of esodeviation, and refractive errors to determine predictive variables.

Main Results:

• Higher degrees of hyperopia (spherical power and spherical equivalent) were observed in the accommodative esotropia (AET) group compared to the non-responder (NAET) group.
• Near esodeviation was significantly smaller in the fully corrected accommodative esotropia (FCAET) group than in the AET group.
• No significant differences were found in visual acuity or anisometropic amblyopia rates among the groups.

Conclusions:

• Patients with larger angles of esodeviation and lower degrees of hyperopia were less likely to respond to glasses.
• Predicting the motor success of accommodative esotropia requires consideration of multiple factors before initiating glasses treatment.
• Individualized assessment is recommended for optimizing outcomes in pediatric esotropia management.