Is the maximum hypermetropic correction necessary in children with fully accommodative esotropia?

MacEwen, C J; Lymburn, Elspeth G; Ho, Whye Onn

doi:10.1136/bjo.2007.126417

Cited by 24 publications

(12 citation statements)

References 21 publications

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“…Based on our findings the aspheric contact lens used does not seem suitable to be fitted on young subjects with the ability to accommodate in order to reduce blur and their accommodative load and consequently achieve the same treatment effect that reading spectacles have [19][20][21][22][23][24][25][26][27][28]. However, a larger study should be conducted to fully evaluate this.…”

Section: Discussionmentioning

confidence: 99%

“…subjects who have a large amount of convergence induced as a result of their accommodation, often suffer from vergence problems such convergence excess [21] at near which also can result in the same symptoms as those with reduced accommodative ability described above [22] or develop a near esotropia and consequently amblyopia [23]. Treatment is by means of reducing the accommodative effort in near vision by reducing the stimulus for accommodation, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment is by means of reducing the accommodative effort in near vision by reducing the stimulus for accommodation, i.e. reducing blur [23].…”

Section: Introductionmentioning

confidence: 99%

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Accommodation in young adults wearing aspheric multifocal soft contact lenses

Pettersson

Ramsay

Lundström

et al. 2011

Journal of Modern Optics

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The aim of the present project was to investigate accommodative behavior in young adults and adolescents fitted with an aspheric multifocal (center distance) contact lens with focus on evaluating whether these lenses can be an alternative treatment for subjects in which a reduced level of blur and thereby accommodation in near vision is aimed at. Twenty normal subjects aged between 21 and 35 years participated in the study. Aberrometry was perfomed using a Zywave TM aberrometer, first on the uncorrected eyes of all subjects, and again while the subjects wore a multifocal contact lens with a þ1.00 add. A Shin-Nippon N Vision-K 5001 Autoref-Keratometer was used to measure accommodative response with two different refractive corrections: (1) habitual spectacle correction only, and (2) habitual correction and a aspheric multifocal (center distance) contact lens. Four hours of adaptation to the lens was allowed. The lag when wearing only the habitual spectacles was compared with the lag while wearing both the habitual spectacles and the aspheric multifocal contact lens. The mean lag of accommodation for the subject group was 0.85 D (AE0.57 SD) and 0.75 D (AE0.52 SD) without and with the multifocal lens, respectively. Statistical analyses showed no difference in lag (t ¼ 0.8479, p ¼ 0.407) with and without the lens. In conclusion, young normal subjects do not relax accommodation when fitted with aspheric multifocal center distance lenses when the addition is þ1.00. It is therefore unlikely that subjects with accommodative ability, in whom the treatment purpose is to reduce blur and thereby accommodation, can be effectively treated with such lenses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accommodation in young adults wearing aspheric multifocal soft contact lenses

Pettersson

Ramsay

Lundström

et al. 2011

Journal of Modern Optics

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“…However, in the PCR under-correction group, in which an under-correction of more than 1.5 D was employed, more caution was needed because there is a greater risk of developing strabismus. MacEwen et al[31] demonstrated that under-correction in fully accommodative esotropia can increase esotropia and that affected children can decompensate to manifest esotropia. Therefore, in the current study, the children in the PCR under-correction group were recruited if strabismus was not observed at the initial visit to avoid the development of strabismus.…”

Section: Discussionmentioning

confidence: 99%

Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

Chang

2017

PLoS ONE

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PurposeThe aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses.MethodsChildren with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more were included, while those who had astigmatism of > 2.0 D or anisometropia of > 2.0 D were excluded. The patients were divided into a full correction group and an under-correction group according to the amount of hyperopia correction applied. The under-correction group was further subdivided into a fixed under-correction group and a post-cycloplegic refraction (PCR) under-correction group. The duration of amblyopia treatment and changes in initial hyperopia were compared between the groups.ResultsIn total, 76 eyes of 38 patients were analyzed in this study. The full correction group and under-correction group were subjected to 5.5 months and 5.9 months of amblyopia treatment, respectively (P = 0.570). However, the PCR under-correction group showed more rapid improvement (2.9 months; P = 0.001). In the under-correction group, initial hyperopia was decreased by -0.28 D and -0.49 D at 6 months and 12 months, respectively, after initial cycloplegic refraction. Moreover, the amount of hyperopia under-correction was correlated with the amount of hyperopia reduction (P = 0.010).ConclusionThe under-correction of moderate to severe hyperopic amblyopia has beneficial effects for treating amblyopia and activating emmetropization. PCR under-correction can more rapidly improve visual acuity, while both fixed under-correction and PCR under-correction can induce emmetropization and effectively reduce initial hyperopia.

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“…In this issue, MacEwen et al 11 ask if the maximum hypermetropic correction is necessary in children with fully accommodative esotropia ( see page ). They describe a prospective study in which children with fully accommodative esotropia were examined and the effect of reduction of their correction by 1 and 2 dioptres from each eye respectively described.…”

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confidence: 99%

Full or partial hypermetropic correction for accommodative esotropia: does it matter?

Nischal

2008

British Journal of Ophthalmology

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Is the maximum hypermetropic correction necessary in children with fully accommodative esotropia?

Cited by 24 publications

References 21 publications

Accommodation in young adults wearing aspheric multifocal soft contact lenses

Accommodation in young adults wearing aspheric multifocal soft contact lenses

Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

Full or partial hypermetropic correction for accommodative esotropia: does it matter?

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