Abstract
Objective:To determine the prognostic factors affecting stereoacuity in patients with refractive accommodative esotropia (RAE) according to the results of long follow- up period.Methods:We reviewed the charts of 70 patients with RAE between the years 1985-2014. Patients were classified into three groups. G-1: Stereoacuity score 40 second/arc. G-2: Stereoacuity score >40 second/arc (50-3000). G-3: No binocular vision. Initiation age of RAE, duration of deviation, refractive error, amblyopia, amblyopia treatment, anisometropia, visual acuity, family history, angle of deviation for distance and near at each group and the prognostic factors affecting stereoacuity were analyzed.Results:The mean initiation age of RAE was 2.7±1.5 years, the mean age at first visit was 6.4±4.2 years. The mean follow up time was 7.3±4.4 years. Seven patients had 40 second/arc, 48 patients had 50 to 3000 second/arc stereoacuity, 15 patients had no binocular vision. Mean deviation for near was statistically higher in group 2 and 3. Visual acuity levels were higher in group 1 and 2 and was statistically significant. Low visual acuity (p=0.001, 0.008), higher angle of deviation at near (p=0.01), increased duration of deviation (p=0.01), presence of amblyopia (p=0.001) and irregularity of amblyopia treatment (p=0.01) were significantly related with poor stereoacuity.Conclusion:According to the prognostic factors low stereoacuity was mostly related with amblyopia as a result the late presentation of the patients in seeking care. Appropriate treatment as full refractive correction and amblyopia treatment during the RAE is important for development of good stereopsis. Also angle of deviation at near and duration of deviation can be a useful predictor for poor stereoacuity levels.
Highlights
Accommodative esotropia is described as convergent deviation of the eyes related with activation of accommodation reflex
Refractive accommodative esotropia (RAE) is induced by uncorrected hyperopia and is related with inadequate divergence, which causes an increase of convergence
Esotropia is treated with full correction of hyperopia by spectacles, contact lenses or refractive surgery.[11,12,13]
Summary
Accommodative esotropia is described as convergent deviation of the eyes related with activation of accommodation reflex. Refractive accommodative esotropia (RAE) includes accommodative convergence, uncorrected hyperopia and inadequate fusional divergence.[1,2,3] Uncorrected hyperopia coerces patient to accommodate to net retinal image. Esotropia will appear if fusional divergence of the patient is inadequate to compensate for increased convergence.[4] Patients treated by prescription of full correction of hyperopia to control esotropia.[1,5,6]
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