This retrospective study includes a disparate group of 39 esotropic patients with an accommodative element from two different clinics with differing prescribing practices. Seven children were excluded due to previous treatment or insufficient follow-up. In all patients single vision glasses were prescribed first with full hyperopic correction. Later, if insufficient control of the deviation at near fixation, a trial of +2.50 or + 3.00 lenses were added on clip-ons over the single lenses. The subjects were split to two groups: 1) seven with progressive addition lenses only and 2) 25 with bifocals first and later switched to progressive addition lenses. In group 1, the near deviation reduced from an average of 28 to 0PD with improvement in stereopsis from mean 113 to 54”. In group 2, the near deviation reduced from an average of 24 to 1.5PD with improvement in stereopsis from mean 541 to 141”. Both treatments were found to be equally beneficial as an initial treatment of young children with convergence excess esotropia with good sensory and motor results. Progressive additional lenses provide correction at an intermediate distance with good cosmesis. However, caution must be exercised when considering results of this retrospective study given the differences in subject numbers across groups.

Progressive addition lenses for accommodative esotropia with a high accommodative element.
Mezer E, Wygnanski-Jaffe T, Stolovich C.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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