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Volume 46, 1996, p. 2933

The "Accomplice" - Accommodative Esotropia (Abstract)
S A S Havertape, D.B.O., C.O.

Accommodative esotropia can be divided into three categories: refractive, abnormal AC:A ratio, and a combination group. Though small in number, patients with esotropia associated with myopia, or with a low AC:A ratio should not be overlooked.


Successful non-surgical treatment of accommodative esotropia depends upon accurate determination and appropriate correction of the refractive error, and also careful assessment of the AC:A ratio. Non-surgical treatment may be as simple as glasses alone to provide good alignment and fusion, or may include additional bifocal lenses, miotics, or orthoptic exercises. Non-surgical treatment is considered successful if fusion is achieved. Unfortunately, 13% of patients have been reported to deteriorate, whereby the esotropia increases and fusion is lost after a period of successful nonsurgical treatment. Such patients require prompt prism adaptation and surgery to restore the previous state of good alignment and fusion.