Characteristics of Esodeviation Related to Hyperopia in Children Aged 4 to 6 Years: A Retrospective Cohort Study.

PURPOSE: To investigate the characteristics of esotropia associated with hyperopia in children aged 4 to 6 years.

METHODS

Medical charts of 142 patients (60 boys and 82 girls; age range, 4-6 years) with esotropia and hyperopia (≥1.5 diopters after cycloplegic refraction) were retrospectively reviewed. Patients were classified into four groups: (1) fully corrected accommodative esotropia (FCAET); (2) accommodative esotropia (AET) with residual deviation ≤8 prism diopters; (3) partially AET (PAET) with residual deviation ≥10 prism diopters; and (4) nonaccommodative esotropia (NAET). Clinical parameters, including best-corrected visual acuity, angle of esodeviation, and refractive errors, were analyzed to identify predictors of esodeviation type.

RESULTS

Female patients were significantly more likely to achieve good control with glasses (p = 0.044). Visual acuity in the better and worse eyes and the prevalence of anisometropic amblyopia did not differ among groups (p = 0.430, p = 0.124, and p = 0.189, respectively). The hyperopia (spherical power) of the AET group was significantly higher than that of the NAET group (p = 0.028), and the spherical equivalent was also more hyperopic in the AET group compared with the NAET group (p = 0.040). Near esodeviation in the FCAET group was significantly smaller than that in the AET group (p = 0.003), whereas esodeviation at distance did not differ among groups (p = 0.115).

CONCLUSIONS

Larger angles of esodeviation and lower degrees of hyperopia were associated with a reduced likelihood of successful correction with glasses. Multiple factors should therefore be considered when predicting motor outcomes of accommodative esotropia prior to a trial of spectacle correction.