J Korean Ophthalmol Soc.  2008 Apr;49(4):617-622. 10.3341/jkos.2008.49.4.617.

Clinical Features of Refractive Accommodative Esotropia According to Degree of Hypermetropia

• Jun JH
• Lee YC
• Lee SY

• KMID: 2211493
• DOI: http://doi.org/10.3341/jkos.2008.49.4.617

Abstract

PURPOSE: This study examined differences in clinical patterns according to the hyperopia level in refractive-accommodative esotropia patients.
METHODS
Ninety-four refractive-accommodative esotropia patients were divided into 3 groups according to hyperopia level: group 1, > or = +1.00D and < +3.00D group 2, > or = +3.00D and < +5.00D and group 3, > or = +5.00D. The following factors were analyzed retrospectively: the initial corrective visual acuity, the final corrective visual acuity, the angle of esotropia with or without hyperopic correction, the recovery time to orthophoria after hyperopic correction, the change in hyperopia level, and the frequency of amblyopia.
RESULTS
The angles of esotropia without hyperopic correction in groups 1, 2 and 3 were 18.4+/-7.3PD, 22.9+/-8.5PD, and 25.7+/-10.4PD, respectively. The angle of esotropia was found to be significantly greater in the group with the higher level of hyperopia (P=0.01). The monthly change in hyperopia in groups 1, 2 and 3 was 0.018+/-0.02D, 0.028+/-0.03D and 0.043+/-0.03D. The change was greater in the group with the higher level of hyperopia (P=0.009).
CONCLUSIONS
In refractive-accommodative esotropia patients, the more the hyperopia without correction increases, the more the angle of esotropia without correction increases, and the larger the reduction of hyperopia after correction becomes.

Keyword

Accommodative; Hyperopia; Refractive

MeSH Terms

Amblyopia
Esotropia
Humans
Hyperopia
Visual Acuity

Reference

References

1. Parks MM. Abnormal accommodative convergence in squint. AMA Arch Ophthalmol. 1958; 59:364–80.

2. Mohney BG. Common forms of childhood esotropia. Ophthalmology. 2001; 108:805–9.

3. Wright KW, Spiegle PH. Esodeviations. Wright KW, editor. Pediatric Ophthalmology and Strabismus. 2nd ed.New York: Springer;2003. chap. 13.

4. Cho YA, Baek SW. Clinical assessment of accommodative esotropia. J Korean Ophthalmol Soc. 1988; 29:371–8.

5. Kim C, Hwang JM. The clinical course of esotropia associated with hypermetropia after initial wearing of glasses. J Korean Ophthalmol Soc. 2003; 44:134–43.

6. Chang JH, Kim MM. Refractive accommodative esotropia associated with mild hyperopia. J Korean Ophthalmol Soc. 2005; 46:1547–54.

7. Lambert SR, Lynn M, Sramek J, Hutcheson KA. Clinical features predictive of successfully weaning from spectacles those children with accommodative esotropia. J AAPOS. 2003; 7:7–13.

8. Yang H, Chang YH, Lee JB. Clinical features of refractive accommodative esotropia and partially accommodative esotropia. J Korean Ophthalmol Soc. 2004; 45:626–30.

9. Choi KS, Chang JH, Chang YH, Lee JB. Occurrence and risk factors of decompensation and additional treatment in refractive accommodative esotropia. J Korean Ophthalmol Soc. 2006; 47:121–6.

10. Pollard ZF. Accommodative esotropia during the first year of life. Arch Ophthalmol. 1976; 94:1912–3.

11. Baker JD, Parks MM. Early onset accommodative esotropia. Am J Ophthalmol. 1980; 90:11–8.

12. von Noorden GK. Binocular Vision and Ocular Motility. 6th ed.St. Louis: Mosby;2002. p. 313.

13. Freeman DN, Marg E. Visual acuity development coincides with the sensitive period in kittens. Nature. 1975; 254:614–5.

14. Sohn HJ, Paik HJ. Clinical features of refractive accommodative esotropia according to the age of onset. J Korean Ophthalmol Soc. 2006; 47:941–6.

15. Parks MM. Concomitant esodeviation. Duane TD, editor. Duane's Clinical Ophthalmology. Philadelphia: Harper & Low;1988. 1:chap.p. 12.

16. Dickey CO, Scott WE. The deterioration of accommodative esotropia: Frequency, characteristics and predictive factors. J Pediatr Ophthalmol Strabismus. 1988; 25:172–5.

17. Kwon J-Y, Lee DE, Song HC. Clinical studies on accommodative esotropia. J Korean Ophthalmol Soc. 1997; 38:687–91.

18. Coats DK, Avilla CW, Paysse EA, et al. Early‐ onset refractive accommodative esotropia. J AAPOS. 1998; 2:275–8.

19. Berk AT, Kocak N, Ellidokuz H. Treatment outcomes in refractive accommodative esotropia. J AAPOS. 2004; 8:384–8.

20. Preslan MW, Beauchamp GR. Accommodative esotropia: review of current practices and controversies. Ophthalmic Surg. 1987; 18:68–72.

21. Troilo D. Neonatal eye growth and emmetropization: a literature review. Eye. 1992; 6:154–60.

22. Saunders KJ, Woodhouse M, Westall CA. Emmetropization in human infancy: rate of change is related to initial refractive error. Vision Res. 1995; 35:1325–8.

23. Atkinson J, Anker S, Bobier W, et al. Normal emmetropization in infants with spectacle correction for hyperopia. Invest Ophthalmol Vis Sci. 2000; 41:3726–31.

24. Na SJ, Choi NY, Park MR, Park SC. Long‐ term follow‐ up results of hyperopic refractive change. J Korean Ophthalmol Soc. 2005; 46:1704–10.

25. Rustein RP, Harsh‐ Tootle W. Clinical course of accommodative esotropia. Optom Vis Sci. 1998; 75:97–102.

26. Raab EL, Spierer A. Persisting accommodative esotropia. Arch Ophthalmol. 1986; 104:1777–9.