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Journal List > J Korean Ophthalmol Soc > v.48(12) > 1007992

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Lee and Kim: Clinical Characteristics of Accommodative Esotropia with Successful Wearing out of Glasses
Original Article

J Korean Ophthalmol Soc 2007;48(12):1699-1705.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.12.1699

Clinical Characteristics of Accommodative Esotropia with Successful Wearing out of Glasses

Tae Yoon Lee, M.D., Myung Mi Kim, M.D.

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea

Address reprint requests to Myung Mi Kim, M.D., Department of Ophthalmology, Yeungnam University College of Medicine, #317-1 Daemyung-dong, Nam-gu, Daegu 705-717, Korea, Tel: 82-53-620-3441, Fax: 82-53-626-5936, E-mail: mmk@med.yu.ac.kr

Received 31 January 2007       Accepted 31 July 2007

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was performed to investigate the characteristics of accommodative esotropia in patients who successfully discontinued their use of glasses and to determine which factors are predictive of successfully discontinuing the use of glasses.

Methods

A retrospective review was performed of 40 patients with accommodative esotropia who were orthophoric without glasses (group A) and 58 patients with persistent esotropia without glasses (group B). The exclusion criteria were as follows: a follow-up of less than 5 years, age younger than 10 years old, less than 1.50 diopters of hyperopia, or previous strabismus surgery. We analyzed the relationships between the factors and the resolution of esotropia.

Results

The mean distance esotropia (30.1 vs 24.3 prism diopters), the degree of hyperopia (+5.3 vs +3.9 diopters) and the interval between the initial prescription of glasses and the initiation of discontinuing their use were predictors of successful discontinuation of glasses in group A and B (p<.05).

Conclusions

Some patients with accommodative esotropia may be successfully weared out of glasses. A smaller esotropic angle, lesser degree of hyperopia, and earlier initiation of wearing appear to be favorable factors.

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Keywords: Accommodative, Esotropia, Glasses

References

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Table 1.
Demographics and initial clinical characteristics of patients in two groups
  Glasses discontinued group (n=40) Glasses still worn group (n=58) P-value
Sex, n (%) 0.056*
 Male 23 (57.5) 22 (37.9)
 Female 17 (42.5) 36 (62.1)
Family History of strabismus, n (%) 2 (5.0) 7 (12.1) 0.302†
Amblyopia, n (%) 13 (32.5) 16 (27.6) 0.600*
High AC/A ratio, n (%) 2 (5.0) 1 (1.7) 0.565†
Age esotropia developed, mo (SD) 24.7 (16.8) 23.0 (15.7) 0.624‡
Age esotropia diagnosed, mo (SD) 44.1 (16.6) 39.8 (17.3) 0.229‡
Age glasses prescribed, mo (SD) 44.3 (16.6) 40.3 (16.7) 0.251‡
Age at last follow-up, yr (SD) 15.7 (2.6) 15.6 (3.0) 0.957‡
Best corrected visual acuity (dominant eye), LogMAR (SD) 0.49 (0.2) 0.52 (0.2) 0.413‡
Best corrected visual acuity (non-dominant eye), LogMAR (SD) 0.66 (0.2) 0.67 (0.3) 0.735‡
Distant esotropia, PD (SD) 24.3 (10.6) 30.1 (10.9) 0.010‡
Near esotroipa, PD (SD) 25.7 (10.6) 30.2 (10.9) 0.046‡
Spherical equivalent (higher eye), D (SD) 4.3 (1.8) 5.9 (2.1) 0.000‡
Spherical equivalent (lower eye), D (SD) 3.9 (1.8) 5.3 (2.1) 0.001‡
Follow-up interval, mo (SD) 144.0 (38.0) 147.4 (39.5) 0.663‡
Total follow-up interval, mo (SD) 146.0 (38.4)

PD = prism diopters; D = diopters.

* Chi-square test;

† Fisher's exact test;

‡ Student t-test.

Table 2.
Clinical characteristics in two groups at final examination
  Glasses discontinued group (n=40) Glassesstill worn group (n=58) P-value
Time between esotropia developed and glasses prescribed, mo (SD) 19.7 (14.8) 17.3 (14.1) 0.434*
Time between esotropia diagnosed and glasses prescribed, mo (SD) 0.2 (0.8) 0.5 (2.7) 0.527*
Age weaning started, mo (SD) 84.8 (17.9) 87.7 (18.3) 0.430*
Time between glasses prescribed and weaning started, mo (SD) 40.5 (20.0) 47.4 (19.1) 0.087*
Amblyopia, n (%) 5 (12.5) 11 (19.0) 0.395†
Best corrected visual acuity (dominant eye), LogMAR (SD) 0.01 (0.05) 0.01 (0.06) 0.969*
Best corrected visual acuity (non-dominant eye), LogMAR (SD) 0.06 (0.17) 0.05 (0.14) 0.965*
Distant esotropia, PD (SD) 1.8 (2.7) 2.7 (3.0) 0.115*
Near esotroipa, PD (SD) 2.7 (3.1) 3.0 (3.0) 0.657*
Spherical equivalent (higher eye), D (SD) 0.9 (1.5) 3.6 (1.8) 0.000*
Spherical equivalent (lower eye), D (SD) 0.4 (1.5) 2.9 (1.9) 0.000*
Decrease of spherical equivalent (higher eye), D (SD) 3.5 (1.6) 2.3 (1.5) 0.000*
Decrease of spherical equivalent (lower eye), D (SD) Age glasses discontinued, yr (SD) 3.6 (1.6) 14.4 (2.4) 2.4 (1.7) 0.001*

PD = prism diopters; D = diopters.

* Student t-test;

† Chi-square test.

Table 3.
Sensory tests in two groups during follow-up
  Glasses discontinued group Glasses still worn group P-value
Lang stereotest passed, % (n) 15.0 (6/40) 31.9 (15/47) 0.066*
Titmus stereotest, sec/arc (SD, n) 542.7 (532.5, 33) 373.0 (509.1, 40) 0.169†
Worth 4-dot test
 Fusion at distance and near, % (n) 52.9 (18/34) 44.4 (16/36) 0.477*
 Fusion at distance, % (n) 52.9 (18/34) 44.4 (16/36) 0.477*
 Fusion at near, % (n) 88.2 (30/34) 83.3 (30/36) 0.736*

sec/arc = seconds/arc.

* Chi-square test;

† Student t-test.

Table 4.
Predictive factors of successful weaning from glasses
Predictive factors Relative risk (95% CI) P-value*
Age esotropia diagnosed (< 4 yr) 0.605 (0.258 to 1.419) 0.248
Age glasses prescribed (< 4 yr) 0.605 (0.258 to 1.419) 0.248
Distant esotropia (< 20PD) 3.046 (1.096 to 8.462) 0.033
Near esotropia (< 20PD) 0.848 (0.255 to 2.823) 0.789
Spherical equivalent (lower eye, < 3D) 5.158 (2.017 to 13.190) 0.001
Age weaning started (< 8 yr) 1.517 (0.586 to 3.925) 0.391
Time between esotropia developed and glasses prescribed (≤ 2 yr) 0.900 (0.399 to 2.032) 0.799
Time between glasses prescribed and weaning started (< 3 yr) 5.158 (2.076 to 12.949) 0.000

CI = confidence interval; PD = prism diopters; D = diopters.

* Cox proportional hazard regression analysis.

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