Treatment of Younger Patients with Accommodative Esotropia

Abstract

Background: Accommodative esotropia (AET) is a common disease during childhood. In this literature review, we analyze and discuss the different methods of treatment for Accommodative esotropia. Methods: Articles about accommodative esotropia from 2007 to 2017 were retrieved from the PubMed database. We study the articles by title/abstract/all fields, after applying the inclusion and exclusion criteria, finally 9 articles were retained. We compared the effectiveness between these approaches to treatment. Results: All the refraction methods had an effectivity rate of > 50%. The bifocal lenses group showed a higher failure rate (15.58%) than the single-vision lenses group (5.19%). Extraocular muscle surgery can significantly decrease deviation in patients who have AET with a high AC/A ratio (95.24%,71.30%,78.40%). After Botulinum toxin injection, the residual deviation was significantly lower than that before the injection (90.44%) and this rate held stable until 12 months after the injection (85.71%) and then decreased to 71.43% at 18 months. The effectivity rate in the prism builders group (surgery with prism group) was significantly higher than that in the prism non-builders group 100% vs. 56.25%). In this review, the average rate of Amblyopia in the accommodative esotropia patient is 41.36%. Conclusions：All the treatment were full or partly effective for accommodative esotropia patients. Early intervention using effective methods of treatment can improve accommodative esotropia patients’ alignment and improve their quality of life. Amblyopia is common in patients with partly accommodative esotropia. Keyword: Accommodative esotropia, Treatment, High AC/A ( accommodative convergence to accommodation ratio ), Amblyopia.