Clinical evaluation of cessation of hyperopia in 123 children with accommodative esotropia treated with glasses for best corrected vision

Purpose: This study aimed to determine age at successful cessation of hyperopic glasses, the influence of hyperopia on the esotropic angle and age at discontinuation of glasses in accommodative esotropia (AE) patients. Methods: We performed a retrospective study in 123 AE patients who achieved complete emmetropization and maintained orthophoria without hyperopic glasses between March 1999 and February 2005. All patients had been prescribed the weakest possible glasses to provide best corrected vision and maintain fusion in hyperopia. Results: Pure AE was found in 64 patients and partial AE in 59. At the initial visit, 56.1% of patients had refractive errors of 3.00-5.00 D (mean cycloplegic spherical equivalent [SE]). The angle of esotropia without correction was 30.90 ± 14.80 prism dioptres (PD) (mean ± standard deviation) in pure AE, and 42.70 ± 15.19 PD in partial AE (p = 0.000). The non-accommodative component in partial AE was 24.07 ± 14.90 PD. The mean age at cessation of glasses use was 13.50 ± 3.81 years. Stereopsis was noted in 70.2% of patients at the initial visit and 96.4% at the last visit. Pearson's correlation coefficients (r) were 0.480 between the degree of hyperopia and amount of optically corrected esotropia (p = 0.000), and 0.434 between the degree of hyperopia and age at successful cessation of corrective glasses use (p = 0.000). Conclusions: The mean age at resolution of hyperopia with good stereopsis was 13.5 years. The degree of hyperopia seemed to correlate with the angle of esotropia and the age of successful cessation of corrective glasses.