Consecutive accommodative esotropia.

This paper reports nine patients who developed accommodative esotropia following correction of intermittent exotropia. Eight cases originally were esotropic; one was esotropic secondary to previous surgery for nonaccommodative esotropia. All had the pattern of "divergence excess." In seven patients recession of both lateral recti had been performed in conventional amounts; one case had a recession/resection procedure, and one case recession of the lateral recti followed by resection of the medial recti. In all cases the consecutive accommodative esotropia included an abnormally high distance/near relationship. All were controlled by appropriate optical or drug treatment, and six cases deteriorated later. Surgical overcorrection was not a prominent contributing factor. Preoperative occlusion and/or the +3.00 D test would not have predicted the persistence of the high distance/near relationship. There were no other obvious indicators of this complication.