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Accommodative esotropia
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Accommodative esotropia
Dr. Rahul
Accommodative esotropiaAccommodative
esotropia is a condition where in excessive effort of accommodation results in an inward deviation of the eyes.
Most often it is caused by uncorrected Hypermetropia.
Acquired Esotropia in a visually immature child is a day time emergency.
The consequences are loss of Binocular vision & onset of amblyopia.
The interval between the time of onset & the treatment determines the visual outcome
Classification
Accommodative esotropia
Refractive Accommodative Esotropia
Non- Refractive
Accommodative
Partially Accommodati
ve (Mixed)
Fully accommodative Accommodative Esotropia which is fully
corrected by optical correction of Hypermetropia is called Refractive Accommodative Esotropia
These children will initially be normal with straight eyes.
Around the age of 18 to 24 months, they try to accommodate to clear the retinal image blur.
**Binocular Vision and OcularMobility: Theory and Management ofStrabismus, Gunter K. Von Noorden
Clinical FeaturesOnset 2-3 yrs of age; but can occur at any age• Initially intermittent & variable
Diplopia
Within 2-3 days suppression
Longer duration leads to Anomalous retinal correspondence
• Develop amblyopia if uncorrected• Normal AC/A ratio• Hypermetropic refractive error (usually between +2 D
to+6)
Accommodative esotropia–without & with glasses
TreatmentFull refractive correction is prescribed, so
that binocular vision can be restored. Child should wear the refractive correctionat all times.
If not, child will not relax the accommodation &
vision will be blurred with glasses
Recommended