Accommodative esotropia

Accommodative esotropia

1. Accommodative esotropia Dr. Rahul

2. Accommodative esotropia Accommodative 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 .

3. 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

4. Classification

5. 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.

6. Around the age of 18 to 24 months, they try to accommodate to clear the retinal image blur.

7. **Binocular Vision and Ocular Mobility: Theory and Management of Strabismus, Gunter K. Von Noorden

8. Clinical Features Onset 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)

9. Accommodative esotropia –without & with glasses

10. Treatment Full refractive correction is prescribed, so that binocular vision can be restored. Child should wear the refractive correction at all times. If not, child will not relax the accommodation & vision will be blurred with glasses