Medical management of accommodative esotropia.

Cycloplegic drugs are the principal medications used in the diagnosis of accommodative esotropia. The same cycloplegics can be used as a "medical patch" in the treatment of amblyopia. Miotics may be as good as glasses in controlling accommodative esotropia but are almost never better. The response to miotics does not rule out the presence of accommodative esotropia. Miotics also may be used as a supplementary agent to glasses, bifocals, or surgery in the treatment of esotropia. The most widely used miotics today include phospholine iodide and DFP with iris cysts being the major local side effect in the eye with the use of miotics in children. Miotics and other drugs are valuable tools in the treatment of accommodative esotropia; however, the use must be correlated with other tools, including surgery, patching, glasses, and orthoptic exercises.