Korean J Ophthalmol.  2005 Mar;19(1):77-79. 10.3341/kjo.2005.19.1.77.

Deterioration of Accommodative Esotropia during Part-time Occlusion Therapy

• Kim S
• Kim S
• Cho YA

• KMID: 1099090
• DOI: http://doi.org/10.3341/kjo.2005.19.1.77

Abstract

The authors report two cases of suddenly deteriorated accommodative esotropia with amblyopia during part-time occlusion therapy. A 7-year-old girl with right accommodative esotropia, which was well controlled, showed marked increase in esodeviation after part-time occlusion and regained orthophoria without occlusion. This phenomenon was repeated. Recession of both medial recti was performed and orthophoria was well maintained at both distant and near targets. Accommodative esotropia of a 9-year-old boy with glasses also showed a striking increase in esodeviation after part-time occlusion. The authors recommended wearing only glasses without occlusion or surgery and he recovered fusion. Three months later, orthophoria was maintained at distant target, with 8PD esophoria at near target with glasses. Although this complication should be considered before occlusion therapy, it must be taken continuously if needed, because an increase of the deviation size with occlusion may simply reflect a true deviation and may not be a poor prognostic sign.

Keyword

Accommodative esotropia; Part-time occlusion therapy; Sudden deterioration

MeSH Terms

*Accommodation, Ocular
Amblyopia/physiopathology/therapy
Child
Esotropia/*etiology/physiopathology
Eyeglasses
Female
Humans
Male
*Sensory Deprivation

Figure

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  Fig. 1 Case 1. Note the right esotropia (left) and orthophoria (right) after surgery.

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  Fig. 2 Case 2. Note the right esotropia (left) and orthophoria (right) after one month without occlusion therapy.

Reference

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