Stereopsis outcome in refractive accommodative esotropia successfully aligned by full hypermetropic correction.

Purpose: To investigate factors associated with stereopsis outcomes in refractive accommodative esotropia (RAET) successfully aligned by full hypermetropic correction.

Study design: Retrospective.

Methods: In 171 patients with RAET, ages at onset, initial visit, and first use of glasses, duration of misalignment, cycloplegic refraction, and ocular deviation were compared between groups based on stereopsis outcome: Group F, fine stereopsis ≤60"; Group C, coarse stereopsis >60" but ≤3000"; and Group N, nil stereopsis.

Results: Groups F, C and N comprised 37, 82 and 52 patients, respectively. Although no differences in initial cycloplegic refraction or duration of misalignment were seen between groups, earlier ages at onset, initial visit, and first use of glasses were associated with stereopsis outcome. Final near deviation with glasses also affected fine stereopsis outcome. Groups F, C and N among the 68 patients with onset at >2 years comprised 29, 39, and 0 patients, respectively. In contrast, the 58 patients with onset at ≤1 year and the 45 patients with onset at >1 but ≤2 years showed significantly worse incidences (Groups F, C and N: 5, 18 and 35 patients and 3, 25 and 17 patients, respectively; p<0.001 each, chi-squared test). In the 103 patients with onset ≤2 years, duration of misalignment ≤4 months was associated with significantly better stereopsis outcome than duration of misalignment >4 months (68% vs 42%, p=0.032; Fisher's exact test).

Conclusions: The most important factor associated with stereopsis outcome was earlier age at onset, with the worst outcome for children with age at onset ≤1 year.