The Accommodative Element in Accommodative Esotropia

Somer, Deniz; Cinar, Fatma Gul; Duman, Sunay

doi:10.1016/j.ajo.2005.12.018

Cited by 14 publications

(5 citation statements)

References 19 publications

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“…Patients with FAET demonstrate better control of ET when given full hypermetropic correction than when undercorrected even by as little as one diopter. [ 23 ] This has led to the practice of providing maximum hypermetropic correction for accommodative ET. All our patients received full hypermetropic correction, and none had discontinued the hypermetropic correction throughout the study period.…”

Section: Discussionmentioning

confidence: 99%

Accommodative esotropia

Sreelatha

Al-Marshoudi

Mameesh

et al. 2022

Oman Journal of Ophthalmology

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AIM:The aim of this study is to determine the outcome of accommodative esotropia (ET) and influencing factors in young Omani children.SUBJECTS AND METHODS:In this retrospective cohort, children diagnosed with accommodative ET who had followed up in a tertiary hospital from 2006 to 2011 were identified. Parameters studied included cycloplegic refraction and its change with time, ocular alignment, binocularity, visual acuity (VA), amblyopia, and requirement for surgery.RESULTS:A total of 51 patients were identified. Twenty-four patients were diagnosed with fully accommodative ET (FAET) and 27 with partially accommodative ET (PAET). The mean (± standard deviation [SD]) age of onset and reporting were 2.6 (±1.58) and 3.2 (±1.84) years in the two groups, respectively. The mean (SD) cycloplegic refraction at presentation was 4.50 (±1.66) in the FAET group and 3.65 (±1.67) in the PAET group. Anisometropia was present in 28% of patients. The mean follow-up period was 4.9 years. The following were detected in the final visit. A reduction in amblyopia from 43% to 6% of patients, binocularity in 75% of patients, and a mean increase of 0.64 (±1.3) D in cycloplegic refraction from the first visit (P= 0.005). The mean angle of deviation at near and distance was 29.86 (±15.21) and 17.80 (±10.14) prism diopters, respectively, in FAET patients and 30.15 (±14.83) and 29.53 (±15.53), respectively, in PAET patients. Thirty-seven percent of the PAET patients underwent surgery within 5 years from diagnosis. All participants in this cohort continued to wear glasses in the last follow-up visit.CONCLUSION:Most children with refractive accommodative ET have an excellent outcome in terms of VA and binocular vision. The PAET group was characterized by delayed reporting, the presence of anisometropia, and lower hypermetropia. Further study is required to determine the possibility of weaning glasses in FAET patients.

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Section: Discussionmentioning

confidence: 99%

Accommodative esotropia

Sreelatha

Al-Marshoudi

Mameesh

et al. 2022

Oman Journal of Ophthalmology

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“…There is a paucity of prospective studies2 in this area, and as previously suggested,3 those studies that have been published are difficult to compare because of a lack of detail as to how the initial hypermetropia was corrected. Details such as how cycloplegia was attained are important.…”

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confidence: 99%

“…There is one final issue of interest; Somer et al 2 showed that children with fully accommodative esotropia were able to avoid decompensation of the deviation by using dynamic retinoscopy to monitor decrease in accommodative amplitude with correction worn as they reduced the correction power by 0.5 dioptre decrements. Reduction in accommodative amplitude with reduction of correction power often meant the child could not be weaned off their correction.…”

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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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“…18,22,25 During the first year, the majority of the refractive change takes place between 3 and 12 months of age as there is little change between birth and 3 months. 2,12,[21][22][23][24][25] An accurate accommodative response, therefore, appears to be in place at the time when the emmetropization process begins.…”

Section: Introductionmentioning

confidence: 99%

“…Binocular accommodative ability assessment with DR gives important information about the binocular status of an infant. [18][19][20][21] If accommodation is full, there is evidence that the baby is able to focus images onto the retina while maintaining binocular vision at near. DR assessment can in theory determine if a child is not esotropic simply because they are not accommodating, or if they are fully accommodating but have a good fusional reserve or some mechanism to overcome the eso drive.…”

Section: Introductionmentioning

confidence: 99%

Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy

Somer¹,

Karabulut²,

Cinar³

et al. 2014

Eye

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Object To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR). Methods Infants (3.5-12 months of age) with Z5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4 ± 2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period. Results Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31 (48%) developed strabismus (Group 2B). The remaining 34 constituted Group 2A. Each of the three groups showed an overall reduction of hyperopia by 0.37 ± 0.25 days per year, 0.50 ± 0.28 days per year, and 0.60 ± 0.20 days per year, respectively. Visual acuity assessments among Groups 1 and 2A revealed normal values (0.2-0.0 LogMAR); among Group 2B 19% were within normal range. Conclusions Binocular accommodative behavior at the initial visit seems to be one of the indicators for pointing out infants at risk of developing strabismus and amblyopia. Prescription of DR-based corrections to hyperopic orthotropic infants does not impede emmetropization and result in normal visual acuities after emmetropization period.

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The Accommodative Element in Accommodative Esotropia

Cited by 14 publications

References 19 publications

Accommodative esotropia

Accommodative esotropia

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

Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy

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