Partially accommodative esotropia is
characterized by having a refractive error
usually more than +2.00), normal AC/A ratio, and
an onset between age six months to five years.
The esotropic angle responds partially to the
spectacle correction of the hyperopia, and the
non-accommodative residual esotropia is managed
surgically.
Partially accommodative esotropia has two
clinical Types:
1. Late onset accommodative ET that develops in
a patient with a history of infantile esotropia.
2. A deterioration of a refractive accommodative
esotropia, previously fully corrected with
spectacles.
Surgery for partially accommodative esotropia is
carried only on the non-accommodative component
of the deviation measured after full cycloplegic
refraction and glasses prescription.
Surgical over-correction of partially
accommodative esotropia is reported to be low, (
2 - 18% ) while under correction is as high as
60%.
If a consecutive exotropia developes following
surgery, the hyperopic spectacle power is
usually reduced so that accommodative
convergence can be used to control the
exodeviation. Surgeons usually consider
consecutive exotropic patients to be surgical
successes if the deviation can be controlled in
this manner.
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