Abstract
This study discusses a specific subset of patients with accommodative esotropia who have a moderate to large amount of hyperopia. All these patients were originally controlled with glasses, but they subsequently developed a secondary exotropia without any surgery. Patients with accommodative esotropia who have amblyopia and moderate to large amounts of hyperopia should be followed closely, as they may develop secondary exotropia. Patients who developed this condition were successfully treated by a reduction of the hyperopic correction alone or in combination with strabismus surgery.