This finding suggests better binocular vision outcome is determined before presentation. Higher grade binocular vision is associated with late presentation rather than early detection and treatment. [bjo.bmj.com]

Sixty-four cases have presented to the Leeds Teaching Hospitals NHS Trust over the last 10 years. This descriptive paper outlines the clinical characteristics of this cohort of patients. [bioj-online.com]

The cases presented demonstrate the management options. [onlinelibrary.wiley.com]

This presentation reviews information on its causes, diagnosis and treatment. 1. Accommodative Esotropia Dominick M. [slideshare.net]

History This usually presents as an acquired, intermittent esotropia. Parents often describe the eyes being straight at times; however will cross when the child is tired or focusing on something up-close. [eyewiki.aao.org]

• Weakness

  Over time, the vision in the eye that crosses can become weak. This is called amblyopia, or lazy eye. Treatment of accommodative esotropia Glasses are prescribed for farsightedness. When the glasses are being worn, the eyes should not cross. [texaschildrens.org]

  […] esotropia is defined as an esotropia greater at near than at distance fixation, unrelated to an uncorrected hypermetropic refractive error and caused by excessive convergence from an increased accommodative effort to overcome a primary or secondary weakness [authorstream.com]

• Fatigue

  During the early stages, the child's eyes may cross only when looking at near targets and is especially noticeable when the child is fatigued or ill. As time passes the problem typically worsens causing the eyes to cross more often. [drmilesburke.com]

  Parents or pediatrician would usually take note of an intermittent deviation when the child is fatigued or ill. If the appropriate optical correction is not given at this insipient stage, the deviation may become constant. [eye.com.ph]

• Pain

  Early intervention can improve the torticollis, reduce neck pain, and lessen the need for regular physical therapy. Ocular causes of torticollis include the following: Congenital nystagmus. [contemporarypediatrics.com]

• Miosis

  […] hemianopsia, Quadrantanopia ) - Color blindness ( Achromatopsia, Dichromacy, Monochromacy ) - Nyctalopia ( Oguchi disease ) - Blindness / Low vision Pupil Anisocoria - Argyll Robertson pupil - Marcus Gunn pupil / Marcus Gunn phenomenon - Adie syndrome - Miosis [psychology.wikia.org]

An eye examination should be a part of the torticollis workup to rule out an ocular cause for the abnormality. Early intervention can improve the torticollis, reduce neck pain, and lessen the need for regular physical therapy. [contemporarypediatrics.com]

A non-accommodative component and amblyopia could set in if treatment is not initiated at the proper time. What are the treatment options for accommodative esotropia? The usual initial intervention done is optical correction. [eye.com.ph]

Photorefractive keratectomy followed by strabismus surgery for the treatment of partly accommodative esotropia. J AAPOS 2004 ; 8: 555 – 9. [journals.sagepub.com]

Treatment To date, there is no consensus on the best treatment for high AC:A ratio accommodative esotropia. [aao.org]

He also argued that if long-term failure rate from optical treatment was high, there was no reason to subject the patients to difficulties for years. [eurotimes.org]

CASE REPORT(S): A 3-year-old girl with behavior problems was referred for amblyopia treatment due to noncompliance with occlusion therapy. [aaopt.org]

Prognosis Some, but not all children, will grow out of accommodative esotropia and will no longer require glasses to have straight eyes. This usually occurs around puberty. [texaschildrens.org]

Accommodative esotropia is the most common form of childhood strabismus and has a favourable prognosis, if appropriate treatment is initiated promptly. [onlinelibrary.wiley.com]

Prognosis Studies have demonstrated binocularity of at least peripheral fusion in around 70% of patients with accommodative esotropia. [eyewiki.aao.org]

[…] with refractive accommodative esotropia. 38 Sefi-Yurdakul N...Koc F 29549487 2019 8 Accommodative esotropia: the state of the art. 38 Lembo A...Nucci P 29332227 2019 9 Acquired, Comitant, Non-Accommodative Esotropia (ANAET): Evaluation, Treatment, and Prognosis [malacards.org]

[…] the eyes) Congenital Esotropia Infantile Esotropia Esotropia with Amblyopia Accommodative Esotropia Partially Accommodative Esotropia Esotropia can be divided into various categories each requiring a different treatment plan; each having a different prognosis [strabismus.org]

Title: Title Etiology Uncorrected hypermetropic refractive error Retinal image blur Makes no effort to accomodate Orthotropia Bilateral ametropic amblyopia Title: Title Etiology Accommodation Accommodative Convergence Insuffficient fusional divergence [authorstream.com]

Etiology Accommodative esotropia is caused by accommodative convergence associated with hyperopia. [eyewiki.aao.org]

It is extremely important to evaluate the cause of the deviation, because the management would vary depending on the etiology. [djo.org.in]

Etiologic factors in accommodative esodeviation. Trans Am Ophthalmol Soc. 1982;80:657–94. pmid:7182971 View Article PubMed/NCBI Google Scholar 2. von Noorden GK, Campos EC. [journals.plos.org]

Epidemiology Race No racial predilection exists. Sex No sex predilection exists. Age This condition usually presents by the age of 2 years. [emedicine.medscape.com]

Management Epidemiological studies show that accommodative esotropia is a common presentation. 1 There is a considerable body of evidence suggesting that correction of hypermetropia should take a central role in the management of accommodative esotropia [onlinelibrary.wiley.com]

Amblyopia is reduced visual acuity due to an abnormal visual experience early in life. [1] Pathophysiology A patient with uncorrected hyperopia must accommodate to clear a blurred retinal image. [emedicine.medscape.com]

Pathophysiology A patient with hyperopia must accommodate to clear a blurred image. Accommodation will stimulate convergence. If fusional divergence is insufficient to compensate for this, an esotropia will develop. [eyewiki.aao.org]

Pathophysiology The mechanism involves a high AC:A ratio, whereby accommodative effort results in an abnormally high convergence response. [aao.org]

Can they wear glasses to prevent developing a squint? Accommodative esotropia is a hereditary condition. Most accommodative esotropes have a history of either farsightedness or squint among first or second degree relatives. [eye.com.ph]

Children with any of these risk factors may benefit from early spectacle correction or preventive therapy, the study authors said. Eileen E. [healio.com]

This amount of esotropia prevents binocular visual development. Some suggest prism adaption with Fresnel prisms prior to surgery. [eyewiki.aao.org]

In most cases, special glasses, bifocals, or early surgery to align the eyes is needed to allow for binocular vision development and to prevent permanent vision loss. [umkelloggeye.org]

However, this reduction in the deviation angle changed the surgical plans and perhaps prevented future consecutive exotropia in some cases. [nature.com]