International Ophthalmology

, Volume 39, Issue 4, pp 883–890 | Cite as

The effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia

  • Nazife Sefi-YurdakulEmail author
  • Hüseyin Kaykısız
  • Feray Koç
Original Paper



To investigate the effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia (RAE).


The records of pediatric cases with full RAE were reviewed; their first and last sensorial and motor findings were evaluated in two groups, classified as partial (Group 1) and full correction (Group 2) of refractive errors.


The mean age at first admission was 5.84 ± 3.62 years in Group 1 (n = 35) and 6.35 ± 3.26 years in Group 2 (n = 46) (p = 0.335). Mean change in best corrected visual acuity (BCVA) was 0.24 ± 0.17 logarithm of the minimum angle of resolution (logMAR) in Group 1 and 0.13 ± 0.16 logMAR in Group 2 (p = 0.001). Duration of deviation, baseline refraction and amount of reduced refraction showed significant effects on change in BCVA (p < 0.05). Significant correlation was determined between binocular vision (BOV), duration of deviation and uncorrected baseline amount of deviation (p < 0.05). The baseline BOV rates were significantly high in fully corrected Group 2, and also were found to have increased in Group 1 (p < 0.05). Change in refraction was − 0.09 ± 1.08 and + 0.35 ± 0.76 diopters in Groups 1 and 2, respectively (p = 0.005). Duration of deviation, baseline refraction and the amount of reduced refraction had significant effects on change in refraction (p < 0.05). Change in deviation without refractive correction was − 0.74 ± 7.22 prism diopters in Group 1 and − 3.24 ± 10.41 prism diopters in Group 2 (p = 0.472). Duration of follow-up and uncorrected baseline deviation showed significant effects on change in deviation (p < 0.05).


Although the BOV rates and BCVA were initially high in fully corrected patients, they finally improved significantly in both the fully and partially corrected patients. Full hypermetropic correction may also cause an increase in the refractive error with a possible negative effect on emmetropization. The negative effect of the duration of deviation on BOV and BCVA demonstrates the significance of early treatment in RAE cases.


Binocular vision Hypermetropia Emmetropization Refractive accommodative esotropia 


Compliance with ethical standards

Conflict of interest

All authors have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

The present study was carried out in accordance with the Helsinki Declaration Principles, after obtaining the approval of the institutional ethics committee.

Informed consent

For this type of study, formal consent is not required.


  1. 1.
    Mohney BG (2007) Common forms of childhood strabismus in an incidence cohort. Am J Ophthalmol 144:465–467CrossRefGoogle Scholar
  2. 2.
    Mulhivill A, MacCann A, Flitcroft I, O’Keefe M (2000) Outcome in refractive accommodative esotropia. Br J Opthalmol 84:746–749CrossRefGoogle Scholar
  3. 3.
    Noorden GK von, Campos EC (2002) Esodeviations. In: Binocular vision and ocular motility. Theory and management of strabismus, 6th ed. CV Mosby, St Louis, pp 311–355Google Scholar
  4. 4.
    Raab EL (1982) Ethiologic factors in accommodative esodeviation. Trans Am Ophthalmol Soc 80:657–694Google Scholar
  5. 5.
    Park KA, Oh SY (2013) The effect of reducing hyperopic correction in patients with accommodative esotropia. J AAPOS 17:363–366CrossRefGoogle Scholar
  6. 6.
    Uretmen O, Köse S, Oztaş Z, Egrilmez S (2007) Factors influencing stereoacuity in refractive accomodative esotropia. Can J Ophthalmol 42:600–604CrossRefGoogle Scholar
  7. 7.
    Berk AT, Koçak N, Ellidokuz H (2004) Treatment outcomes in refractive accommodative esotropia. J AAPOS 8:384–388CrossRefGoogle Scholar
  8. 8.
    Fawcett SL, Birch EE (2003) Risk factors for abnormal binocular vision after successful aligment of accommodative esotropia. J AAPOS 7:256–262CrossRefGoogle Scholar
  9. 9.
    Guclu H, Gurlu VP, Ozal SA, Ozkurt ZG (2015) Prognostic factors for stereopsis in refractive accommodative esotropia. Pak J Med Sci 31:807–811Google Scholar
  10. 10.
    Cho YA, Yi S, Kim SW (2009) Clinical evaluation of cessation of hyperopia in 123 children with accommodative esotropia treated with glasses for best corrected vision. Acta Ophthalmol 87:532–537CrossRefGoogle Scholar
  11. 11.
    Lambert SR, Lynn MJ (2006) Longitudinal changes in the spherical equivalent refractive error of children with accommodative esotropia. Br J Opthalmol 90:357–361CrossRefGoogle Scholar
  12. 12.
    Park KA, Oh SY (2016) Early alignment versus delayed alignment in patients with hyperopia and esotropia. J AAPOS 20:3–6CrossRefGoogle Scholar
  13. 13.
    Wilson ME, Bluestein EC, Parks MM (1993) Binocularity in accommodative esotropia. J Pediatr Ophthalmol Strabismus 30:233–236Google Scholar
  14. 14.
    Flitcroft DI (1998) A model of the contribution of oculomotor and optical factors to emmetropization and myopia. Vis Res 38:2869–2879CrossRefGoogle Scholar
  15. 15.
    Ingram RM, Gill LE, Lambert TW (2000) Effect of spectacles on changes of spherical hypermetropia in infants who did, and did not, have strabismus. Br J Ophthalmol 84:324–326CrossRefGoogle Scholar
  16. 16.
    Park KA, Kim SA, Oh SY (2010) Long-term changes in refractive error in patients with accommodative esotropia. Ophthalmology 117(2196–2207):e1Google Scholar
  17. 17.
    Hutcheson KA, Ellish NJ, Lambert SR (2003) Weaning children with accommodative esotropia out of spectacles: a pilot study. Br J Ophthalmol 87:4–7CrossRefGoogle Scholar
  18. 18.
    Cho YA, Ryu WY (2015) Changes in refractive error in patients with accommodative esotropia after being weaned from hyperopic correction. Br J Ophthalmol 99:680–684CrossRefGoogle Scholar
  19. 19.
    Yang HK, Choi JY, Kim DH, Hwang JM (2014) Changes in refractive errors related to spectacle correction of hyperopia. PLoS ONE 9:e110663. CrossRefGoogle Scholar
  20. 20.
    Demirkılınç Biler E, Üretmen Ö, Köse S (2010) The effect of optical correction on refractive development in children with accommodative esotropia. J AAPOS 14:305–310CrossRefGoogle Scholar
  21. 21.
    Lambert SR, Lynn M, Sramek J, Hutcheson KA (2003) Clinical features predictive of successfully weaning from spectacles those children with accommodative esotropia. J AAPOS 7:7–13CrossRefGoogle Scholar
  22. 22.
    MacEwen CJ, Lymburn EG, Ho WO (2008) Is the maximum hypermetropic correction necessary in children with fully accommodative esotropia? Br J Ophthalmol 92:1329–1332CrossRefGoogle Scholar
  23. 23.
    Kim WJ, Kim MM (2014) Accommodative esotropia who needs spectacles for good ocular alignment after refractive shift below +2.00 diopters. Korean J Ophthalmol 28:417–422CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Nazife Sefi-Yurdakul
    • 1
    Email author
  • Hüseyin Kaykısız
    • 2
  • Feray Koç
    • 3
  1. 1.Department of OphthalmologyBaşkent University HospitalİzmirTurkey
  2. 2.Bitlis State HospitalBitlisTurkey
  3. 3.Atatürk Education and Research HospitalİzmirTurkey

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