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Related Experiment Videos

Accommodative esotropia in adults

S Shippman1, A C Weseley, K R Cohen

  • 1Department of Orthoptics, New York Eye and Ear Infirmary, NY 10003.

Journal of Pediatric Ophthalmology and Strabismus
|November 1, 1993
PubMed
Summary
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Adults with a history of accommodative esotropia may experience a situational increase in their accommodative convergence/accommodation (AC/A) ratio. This change, linked to correcting facultative hyperopia, highlights the need for full prescription correction before considering prisms or surgery.

Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • The accommodative convergence/accommodation (AC/A) ratio is traditionally considered a stable physiological parameter throughout life.
  • Accommodative esotropia is a condition where excessive accommodation leads to inward turning of the eyes.
  • Facultative hyperopia refers to a condition where individuals can overcome hyperopia through accommodation.

Purpose of the Study:

  • To investigate the phenomenon of a situational increase in the AC/A ratio in adult patients.
  • To explore the relationship between accommodative esotropia, facultative hyperopia, and changes in the AC/A ratio.
  • To emphasize appropriate management strategies for adults presenting with esotropia and a history of accommodative issues.

Main Methods:

Related Experiment Videos

  • Case series presentation of 11 adult patients.
  • Clinical evaluation of patients with a history of accommodative esotropia.
  • Analysis of AC/A ratio changes in relation to refractive correction and visual effort.

    • Main Results:

    • Eleven adult patients demonstrated a situational increase in their AC/A ratio.
    • This increase was observed in patients with a history of accommodative esotropia, with or without a nonaccommodative component.
    • The situational AC/A ratio increase appeared to be a response to the effort required to correct facultative hyperopia.

    Conclusions:

    • The AC/A ratio may not be fixed throughout life and can exhibit situational variability in certain adult patients.
    • Adults with acute onset concomitant esotropia and a history of accommodative esotropia require a full refractive correction.
    • Prioritizing full prescription correction before considering prisms or surgical intervention is crucial for managing these patients.