eMedicine Specialties > Ophthalmology > Extraocular Muscles

Esotropia, Accommodative: Treatment & Medication

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

Treatment

Medical Care

  • Prescription of the full amount of hyperopic correction provides adequate treatment for refractive (accommodative) esotropia in 75% of cases.
  • Anticholinesterase drops or ointments in patients with a normal AC/A ratio are not as effective as glasses.
  • In cases of amblyopia, early treatment by patching the normal eye is the mainstay of treatment.

Surgical Care

  • Surgery may be required if the esodeviation becomes refractory to optical treatment. Surgery often is needed when treatment is delayed.
  • Surgical treatment typically entails recession or weakening of the inward-pulling medial rectus muscle in each eye. In cases involving amblyopia, surgery can be limited to only the amblyopic eye by performing a recession of the medial rectus and a resection or strengthening of the lateral rectus.
  • Surgery is performed for the nonaccommodative component only. The operation is not intended to discontinue use of glasses.

More on Esotropia, Accommodative

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

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.

Further Reading

Keywords

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

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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