J Korean Ophthalmol Soc.  2010 Dec;51(12):1630-1638.

Clinical Outcomes of Refractive Accommodative Esotropia in Korean Adolescent Patients

• Kim TK
• Kang NY

Abstract

PURPOSE
To report the clinical course of refractive accommodative esotropia (AE) and to determine whether the strabismus resolves during the adolescent years in Korean patients.
METHODS
A total of 32 adolescent patients with AE associated with hyperopia were retrospectively reviewed. Ocular alignments, amblyopia, stereopsis, changes in refractive error with time after glasses prescribed, and clinical characteristics were studied.
RESULTS
The mean age and follow-up were 14.9 and 10.1 years, respectively at the final visit. The Initial and final refractive errors were 5.16 and 2.52 diopters (D), respectively. Spectacles were initiated at a mean age of 4.7 years, and intentional undercorrection initiated from a mean age of 6.3 years. Hyperopic reduction after prescribing glasses followed the formula: Diopter (D) = 5.23 - 0.02 (Time) - 0.03 (Time)**2. Initially, 16 out of 32 patients (50%) showed fully corrected hyperopia, and eventually, 71.9% wore partially corrected spectacles. The mean change of hyperopia per year was 0.26 D. Six out of 32 patients (18.8%) were successfully discontinued from hyperopic spectacles and the mean age of weaning was 14.7 years. Intentional initial undercorrection did not affect hyperopic reduction (p = 0.123).
CONCLUSIONS
AE persists through adolescence for a majority of Korean patients. These patients need to be carefully monitored during follow-up periods because most do not outgrow their hyperopia and need to using spectacles.

Keyword

Adolescent; Hyperopic reduction; Refractive accommodative esotropia; Weaning

MeSH Terms

Adolescent
Amblyopia
Depth Perception
Esotropia
Eyeglasses
Follow-Up Studies
Glass
Humans
Hyperopia
Refractive Errors
Retrospective Studies
Strabismus
Weaning

Figure

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  Figure 1. Types of deviation at final visit at distance fixation.

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  Figure 2. Range of refractive errors. SE means spherical equivalents.

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  Figure 3. (A) Hyperopic reduction according to the time after glasses prescribed. (B) Hyperopic reduction according to age.

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  Figure 4. Change in hyperopia before and after age 7 years.

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  Figure 5. Changes of hyperopia from the initial visit to the final visit vs the initial hyperopia.

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  Figure 6. Decrease of hyperopia in glasses and weaned group.

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