eMedicine Specialties > Ophthalmology > Extraocular Muscles

Esotropia, Accommodative: Follow-up

Author: Christopher T Noyes, MD, Private Practice, Texas Family Medicine
Coauthor(s): Raghav R Gupta, MD, Consulting Staff, Department of Ophthalmology, Vista Ophthalmology, Medical Center of Plano, and Presbyterian Hospital of Plano
Contributor Information and Disclosures

Updated: Nov 7, 2007

Follow-up

Further Outpatient Care

  • Patients who are treated for amblyopia should be seen at 1- to 4-month intervals depending on their age.
  • Stable patients are typically seen every 6 months.
  • Cycloplegic refraction is repeated at least annually and any time esotropia worsens.

Prognosis

  • Permanent vision loss can occur if strabismus and amblyopia are not treated before patients are 4-6 years.
  • Early treatment of amblyopia may result in improved vision, leading to a better prognosis for binocular vision development and a more stable alignment for surgery if required.
  • With patients aged 4-5 years, one can attempt to reduce the strength of the hyperopic correction to enhance fusional divergence and to maximize visual acuity.
  • If glasses are worn faithfully and fusional patterns are established, many patients with refractive esotropia can maintain straight eyes without wearing glasses by the time they are teenagers.

Miscellaneous

Medicolegal Pitfalls

  • Failure to emphasize to parents of young patients that regular follow-up care is necessary to evaluate for and treat amblyopia
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor, D Brian Stidham, MD, to the development and writing of this article.



More on Esotropia, Accommodative

Overview: Esotropia, Accommodative
Differential Diagnoses & Workup: Esotropia, Accommodative
Treatment & Medication: Esotropia, Accommodative
Follow-up: Esotropia, Accommodative
References
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References

  1. Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy. 1999.

  2. Berson FG. Basic Ophthalmology for Medical Students and Primary Care Residents. 1993.

  3. Catalano RA, Nelson LB. Pediatric Ophthalmology: A Text Atlas. 1994.

  4. Helveston EM, Ellis FD. Pediatric Ophthalmology Practice. 1980.

  5. Kunimoto DY, et al. The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 2004.

  6. Wright KW, et al. Pediatric Ophthalmology and Strabismus. 1995.

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Further Reading

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Keywords

refractive accommodative esotropia, accommodative esotropia, strabismus, eye misalignment, misalignment of eyes, inward deviation of eye, inward eye deviation, hyperope, hyperopia, farsighted, farsightedness

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Contributor Information and Disclosures

Author

Christopher T Noyes, MD, Private Practice, Texas Family Medicine
Christopher T Noyes, MD is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, and Texas Academy of Family Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Raghav R Gupta, MD, Consulting Staff, Department of Ophthalmology, Vista Ophthalmology, Medical Center of Plano, and Presbyterian Hospital of Plano
Disclosure: eMedicine Honoraria Other

Medical Editor

Gerhard W Cibis, MD, Director of Pediatric Ophthalmology Service, Clinical Professor, Clinical Professor, Department of Ophthalmology, Department of Ophthalmology, University of Kansas; Director, Children's Mercy Hospital, University of Missouri at Kansas City
Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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