Cycloplegic refractions as a function of age in children with infantile esotropia.

Abstract

Purpose: To describe cycloplegic refractions as a function of age in children with infantile esotropia.

Methods: An institutional retrospective medical record review was performed for children with infantile esotropia. Only children with at least 3 years followup and at least 2 separate cycloplegic refractions at least 3 years apart were included. Children with developmental delay, neurological disorder, or other significant ocular disease were excluded. The spherical equivalents of the cycloplegic and the amounts of minus cylinder in diopters (D) were grouped according to patient age in years at the time of the refraction.(less than 2y, 2-4y, 5-7y, 8-10y), For the right eye, mean spherical equivalent and minus cylinder at less than 2y were compared with the 8-10y category. For these 2 comparisons, the alpha cutoff preset at 0.05/2=0.025.

Results: One hundred thirteen patients were included in the study. Forty (35%) had initial amblyopia (12 [30%] mild, 25 [62%] moderate, 3 [8%] severe), which was treated with patching. Mean spherical equivalent (less than 2y, 1.73D, number of eyes [n] =61) decreased (8-10y, 1.3D, n=50) but the difference (-0.43D)was not significant by the unpaired 2-tailed t-test (p=0.052, 95% confidence interval [CI]: 0 to -0.86D). Mean minus cylinder (less than 2y, 0.39D) increased (8-10y, 0.71D) but the difference (0.32D) was not significant by the unpaired 2-tailed t-test (p=0.041, 95% CI:0.01 to 0.63D). Data for the left eye were similar.

Conclusions: The average cycloplegic refraction of otherwise healthy children with infantile esotropia is a mild hyperopic spherical equivalent with mild astigmatism that is relatively stable during the first decade of life.