Abstract
We investigated longitudinal changes in the spherical equivalent refractive error (SE) in hyperopic children with or without refractive accommodative esotropia (AccET). A total of 456 patients met the inclusion criteria: 190 (41.7%) in the hyperopic control group and 266 (58.3%) in the AccET group. All patients received at least 3 years of follow-up after spectacle prescription. Subgroups were divided according to age when spectacles were prescribed, presence of amblyopia, or initial SE. Longitudinal changes in SE in children with hyperopia showed a gradual decrease, although SE of younger children with AccET increased over the first 4 years and then decreased thereafter. SE in eye with higher SE was tended to decrease significantly in patient with Acc ET than hyperopic control group (group × time p = 0.015). Amblyopic eyes showed a greater decreased in SE compared with non-amblyopic eyes, but it was not statistically significant (p = 0.07). SE was significantly decreased in children with more hyperopia (≥ 3 D) compared with children with less hyperopia (<3 D) (p = 0.008). Emmetropization of hyperopia was faster in hyperopic patients without AccET and could be affected by the age of the initial spectacles prescription, initial amount of SE, or presence of amblyopia.
Highlights
Esotropia is a disorder of ocular malalignment characterized by an inward deviation of the eyes and is diagnosed in up to 1 in 25 children [1,2]
Accommodative esotropia is a type of esotropia that occurs due to efforts of accommodation, and if eye position is fully corrected with hyperopic correction, it is called refractive accommodative esotropia (AccET)
AccET is a type of strabismus that is caused by accommodative convergence associated with hyperopia, and most children with AccET can improve their binocular vision with long-term proper treatment [14,15]
Summary
Esotropia is a disorder of ocular malalignment characterized by an inward deviation of the eyes and is diagnosed in up to 1 in 25 children [1,2]. AccET is accompanied by hyperopia and astigmatism, and it is initially treated by wearing glasses for full refractive error correction. Even after hyperopic refractive errors have been corrected, there are some cases where decompensated AccET or visual development disorders such as amblyopia occur [8,9]. The amount of hyperopia and the angle of esotropia in children with AccET tend to decrease after spectacle prescription, and as children age, some may discontinue spectacle wear [10,11]. We compare the long-term changes in refractive errors between hyperopic children with and without AccET, and investigated the effect of amblyopia, initial diopters and age of first spectacles prescription on changes in refractive error
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
