Management of Partially Accommodative Esotropia: A case report

Abstract

BackgroundPartially accommodative esotropia show a reduction in the angle of esotropia when wearing spectacles but have a residual esotropia despite the provision of the full hyperopic correction. Amblyopia is common and thus the chance for achieving fusion and high-grade stereopsis is usually not high in this group. This case to report management of partially accommodative esotropia with amblyopia in children. Case presentationSix years old girl came with her mother to the Pediatric and Strabismus division of Cicendo National Eye Hospital with a chief complaint of esodeviation in the left eye 4 years ago. No previous history of trauma or illness.Lensometer result RE S +1.50 C-1.25 x140 LE S+4.25 C-3.00 x170. The best-corrected visual acuity was 0.63 on RE and 0.5 on LE. Ocular movements were good in all directions. Hirschberg test without spectacles showed left esotropia 300 and with spectacles left esotropia 150.Worth Four Dot Test (WFDT) and TNO test showed suppression in LE with stereopsis more than 2000 minutes of arc, respectively anterior and posterior segment within the normal limit in both eyes. She was diagnosed with partially accommodative esotropia. She underwent bilateral medial rectus recession to treat partially accommodative esotropia. There was an improvement in the patient's eye alignment. She had orthotropic eye alignment with spectacle correction of the full amount of hyperopia after one week follows up. ConclusionsThe goal therapy for partially accommodative esotropia is not to operate the patient out of spectacles, but rather to achieve alignment and fusion with full hyperopia correction.