Cycloplegic refractions in children who never wore and who always wore prescribed spectacles for refractive accommodative esotropia: exploring the natural history of this form of strabismus and the effect of treatment on their hyperopia.

PURPOSE: To compare cycloplegic refractions in accommodative esotropes who never and who always wore prescribed spectacles.

METHODS

An institutional retrospective medical record review was performed for children with fully or partially refractive accommodative esotropia without neurological or other ocular disease. Only children with a least 3 years (y) follow-up, at least 2 separate cycloplegic refractions at least 3y apart, and clear documentation of full compliance and conplete non-complicance with prescribed spectacles were studied.

RESULTS

For the right eye, average youngest (less than 2y) and oldest (8-10Y) spherical equivalents were significantly lower in non-compliant children (3.3D [n=25] and 2.49D [n=13]) than in compliant children (5.5D [n=8] and 4.69D [n=25]). The differences in mean hyperopia between less than 2y and 8-10y for the non-compliant (-0.81D) and compliant (-0.84D) children were similar as were levels of mean cylinder.

CONCLUSIONS

The differences in average spherical equivalent and average degree of astigmatism between less than 2y and 8-10 y (slight decrease and slight increase, respectively were similar for children who never and children who always wore prescribed glasses for refractive accommodatiave esotropia. Although full-time glasses wear did not appear to affect refractive shifts, limitations of this retrospective study include a lack of statistical power to detect differences less than 2D.