Accommodative Esotropia Treatment & Management

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


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.