Refractive Profile and Angle of Deviation in Patients with Congenital Esotropia and Congenital Exotropia.

Purpose: To compare refractive error and angle of deviation in patients with congenital esotropia (CET) and congenital exotropia (CXT).

Methods: This retrospective study reviewed the medical documents of 246 patients with CET (n = 206) and CXT (n = 40) admitted to Farabi Eye Hospital, Iran, from 2012 to 2022. All patients were between 6 and 12 months old at the time of admission. Refractive error components and angles of deviation in these patients were recorded and analyzed.

Results: In patients with CET, the mean sphere, cylinder, and spherical equivalent (SE) were 2.59 ± 2.28 diopters (D), -0.42 ± 0.57 D, and 2.38 ± 2.28 D, respectively. Also, the mean horizontal deviation at near was 45.5 ± 12.3 prism diopters (Δ) (range, 20-98 Δ). The most common range was 44-55 Δ (40%), followed by 33-44 Δ (28%) and 55-65 Δ (12%). On the other hand, the mean sphere, cylinder, and SE in patients with CXT were 1.88 ± 1.84 D, -0.39 ± 0.69 D, and 1.69 ± 1.74 D, respectively. Also, the mean horizontal deviation at near was 45.0 ± 17.1 Δ (range, 20-105 Δ). For the CXT group, deviation ranges of 33-44 Δ (37%), 44-55 Δ (32%), and 22-33 Δ (15%) were most prevalent. The mean sphere and SE were significantly higher in the CET group than in the CXT group (P = 0.010).

Conclusion: This study found a distinct refractive profile and distribution of the angle of deviation in patients with CET versus CXT. Patients with CET demonstrated significantly greater hyperopia than those with CXT.