Accommodative Esotropia Treatment & Management

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

Medical Care

Prescription of the full amount of hyperopic correction provides adequate treatment for refractive (accommodative) esotropia in 75% of cases. [2, 3]

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.

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Surgical Care

Surgery may be required if the esodeviation becomes refractory to optical treatment. Surgery often is needed when treatment is delayed. [4]

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.

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