Monovision for treatment of accommodative esotropia with a high AC/A ratio

Abstract

Purpose: The purpose of this study was to determine whether monovision will successfully reduce the near esodeviation in patients with high AC/A ratio accommodative esotropia. Methods: The records of all patients who wore monovision contact lenses for at least 3 months were retrospectively reviewed to determine baseline patient characteristics, long-term motor alignment, sensory status, and patient convenience. Results: Ten patients 10 to 28 years of age wore monovision contact lenses for a mean of 28.7 months to date. All patients maintained an esodeviation of ≤10 prism diopters at distance and near, except 1 patient whose near esodeviation increased over time. Of the 5 patients for whom data were available, 1 experienced a significant decrease in stereoacuity. No patients discontinued monovision because of visual symptoms; however, 1 did so because of the inconvenience of contact lens care. No serious ocular side effects from contact lens wear were noted in the study. Conclusion: Use of monovision contact lenses is a safe and effective method of reducing near-angle esodeviation associated with nonrefractive high AC/A ratio accommodative esotropia. Many patients are willing to accept the visual compromises inherent in monovision to eliminate wearing bifocal spectacles. (J AAPOS 1999;3:87-90)