Long-term treatment results of accommodative esotropia

PurposeTo report the long-term ocular alignment outcomes of patients with accommodative esotropia.MethodsThe medical records of consecutive patients ≤12 year of age diagnosed with refractive accommodative esotropia (esotropia eliminated or decreased to within 10Δ with full hyperopic correction) and followed for at least 10 years were retrospectively reviewed.ResultsA total of 107 patients were included (mean age, 4.81 ± 2.64 years). The mean follow-up period was 12.02 ± 2.25 years (range, 10-21 years). At the first examination performed 10 years after spectacle correction (mean, 10.2 years), 85 patients (79%) had orthophoria or esotropia ≤10Δ at both near and distance fixation, 14 (13%) had consecutive exotropia, 5 (5%) had decompensation and 3 (3%) had esotropia with a high ratio of accommodative convergence to accommodation (AC/A). The mean time interval between presentation and prescription of full hyperopic correction, initial cycloplegic refraction, and presence of amblyopia was not associated with consecutive exotropia, decompensation, or a high AC/A ratio esotropia.ConclusionsWhereas most patients with refractive accommodative esotropia maintained normal long-term ocular motility with spectacle treatment, some developed consecutive exotropia, nonaccommodative esotropia, or esotropia with a high AC/A ratio.