Journal List > J Korean Ophthalmol Soc > v.49(3) > 1008216

Kang, Park, and Park: Clinical Features of Refractive Accommodative Esotropia: Long-term Study



To analyze the long-term clinical features and functional outcomes of refractive accommodative esotropia.


Initial and final age, cycloplegic refraction, distance and near deviation with and without correction, stereoacuity and incidence of amblyopia were evaluated in 45 patients with accommodative esotropia.


The follow-up duration was 65.77±43.98 (6∼151) months, and the mean age was 4.02±1.97 and 9.42±3.77 years at the first and final visits, respectively. The cycloplegic refraction was decreased from 5.16±1.92 diopters (D) to 4.41±1.83D, averaging −0.09±0.40D annually (P<0.01). Of these hyperopic eyes, 55 (61.1%) experienced a decrease, 22 (24.4%) an increase, and 5 (5.6%) showed no changes. From 5 (31.2%) to 12 (75.0%) of 16 patients had a stereoacuity of 100 sec/arc or better (p<0.01). Fusion was achieved in 14 (87.5%) at the final visit, up from 11 (68.8%) at the first visit (P=0.39); 23 (51.1%) of the patients were amblyopic; and anisometropia was found in 9 (39.1%) patients.


Patients whose esotropia was corrected with full cycloplegic hyperopic correction show decreased longitudinal changes in spherical equivalent refractive error with a time course and have excellent binocularity outcomes.


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Table 1.
Changes in hyperopia with correction
  Number of eyes Initial refraction
Final refraction
Annual change in hyperopia
≤5D* 45 3.73±0.82D 3.25±1.70D −0.02±0.27D 0.14
>5D 45 6.67±1.45D 5.28±1.59D −0.19±0.44D <0.01
Total 90 5.16±1.92D 4.41±1.83D −0.09±0.40D <0.01

* D=diopters

Wilcoxon test.

Table 2.
Binocular function according to amblyopia
    Number of patients (%)
First visit Final visit P*
Stereoacuity (≤100 sec/arc) Total (n=16) 5 (31.2%) 12 (75.0%) 0.03
Amblyopic (n=9) 2 (22.2%) 6 (66.7%) 0.18
Non-amblyopic (n=7) 3 (42.9%) 6 (85.7%) 0.24
Fusion at near and distance Total (n=16) 11 (68.8%) 14 (87.5%) 0.39
Amblyopic (n=9) 6 (66.7%) 8 (88.9%) 0.57
Non-amblyopic (n=7) 5 (71.4%) 6 (85.7%) 1

* Fisher exact test.

Table 3.
Mean amount of deviation angle with or without correction
  Amount of deviation angle (PD*)
First visit Final visit P
Without correction Near 29.18±9.40 11.44±12.72 <0.01
Distance 26.48±8.93 11.29±12.57 <0.01
With correction Near 2.83±5.53 1.72±3.22 0.26
Distance 1.73±4.29 0.71±2.18 0.16

* PD=prism diopters

paired t-test.

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