Accommodative Esotropia

Updated: Jul 26, 2016
  • Author: Chris Noyes, MD, FAAFP; Chief Editor: Hampton Roy, Sr, MD  more...
  • Print
Overview

Background

Strabismus is misalignment of the eyes such that both eyes are not simultaneously directed at the same object. Esotropia is a type of strabismus characterized by an inward deviation of one eye relative to the other eye. Accommodative esotropia (refractive accommodative esotropia) is an esodeviation due to normal accommodation in uncorrected hyperopia. The AC/A (accommodative convergence/accommodation) ratio gives the relationship between the amount of convergence (in-turning of the eyes) that is generated by a given amount of accommodation (focusing effort). Amblyopia is reduced visual acuity due to an abnormal visual experience early in life. [1]

Next:

Pathophysiology

A patient with uncorrected hyperopia must accommodate to clear a blurred retinal image. This process of accommodation will stimulate convergence and strain fusional divergence. When fusional divergence is overcome, the eyes cross. The patient with uncorrected hyperopia can see either a single blurred image or a double image in which one image is clear and one image is blurred. Over time, the blurred image can be suppressed; fixation can alternate; or, more commonly, amblyopia can occur.

Previous
Next:

Epidemiology

Race

No racial predilection exists.

Sex

No sex predilection exists.

Age

This condition usually presents by the age of 2 years.

Previous