Early refractive correction promotes esotropia control
Reviewed by Fiona Rowe

This study sought to determine the incidence and characteristics of esotropia in a Northern Ireland population of children <7 years old in a one-year period. The authors report a 2013 cohort in which the area catchment had 29,365 children under the age of seven years and referrals of 430 children with suspected strabismus. Esotropia was present in 117; 62 males, 55 females aged 4-78 months. Diagnosis was fully accommodative esotropia (FAET) in 51, partially accommodative esotropia (PAET) in 57 and nine with non-accommodative esotropia. Children with FAET had shorter delay between age at when esotropia was noticed to age when glasses were worn full-time (1.94 ±6.4m) compared to PAET (6.24 ±8.36m). Higher average spherical equivalent refraction was associated with higher likelihood of being FAET. Longer delays from detection and diagnosis to glasses prescription were associated with reduced likelihood of FAET. The authors conclude that children with recent onset concomitant esotropia require immediate cycloplegic refraction and prescription of full hypermetropia with full-time glasses wear.

Esotropia outcomes and the influence of delay to wearing full hypermetropic correction.
Brennan R, McCance P, Yeong JL, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2020;57:85-9.