Prognosis for Accommodative Esotropia Treated with Bifocals

Abstract

Bifocal glasses are a common form of therapy for accommodative esotropia with a high AC/A ratio. Patients who respond to bifocal therapy show a reduced deviation with fusion, when using the bifocal.

A retrospective study of patients who were initial bifocal responders was undertaken. Patients were divided into two groups: Group 1 (25 patients) were bifocal successes, in whom fusion was maintained over time and the bifocals were discontinued. Group 2 (19 patients) were bifocal failures, in whom fusion was lost, esotropia increased, and surgery was required. The purpose of this paper was to determine patient characteristics that can be used to identify those who may deteriorate and require surgery, and to determine the incidence of deterioration.

A statistically significant difference was found, at the .05 level by the t-test, in the initial refractive error of groups 1 and 2. A statistically significant difference was also found, at the .001 level by the t-test, in the amount of distance deviation at onset of bifocal therapy.

• accommodative esotropia
• high AC/A
• bifocal responders
• deterioration
• bifocal success