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