الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Accommodative esotropia is the most common form of
childhood esotropia. It usually presents in a child between two and
three years of age. The angle of esodeviation is equal for distance and
near in refractive accommodative esotropia, in which the
accommodative convergence/accommodation ratio is normal. It is
usually diagnosed when an esodeviation is decreased with full
cycloplegic correction and the residual deviations at distance and near
fixation are less than 8D-10D. The mainstay of treatment is to correct
hyperopia by full cycloplegic refraction and if any amblyopia is
present this should be treated. Amblyopia is treated by part time
patching of the sound eye for four to six hours daily. Most children
with accommodative esotropia should have a favorable prognosis for
binocular vision since the deviation usually develops after age two.
The study included 60 patients of both genders diagnosed with
refractive accommodative esotropia and treated by given full
cycloplegic refraction and with part time patching of the sound eye if
amblyopia was present. Among the cases of the study 30 (50%) of
them were amblyopic and 20 (33.33%) of them had anisometropia.
The mean uncorrected visual acuity in the right eye was
0.39±0.28 and 0.38±0.25 in the left eye which was corrected by
glasses to 0.12±0.22 in the right eye and 0.11±0.15 in the left eye in
the most recent examination.
Direction of change in hypermetropia was studied in 64 eyes
(32 patients) who were less than 7 years old. Of these hyperopic eyes,
28 experienced an increase, 8 a decrease, and 28 had no change. For
Summary
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those with age more than 7 years (56 eyes), 12 experienced an
increase, 40 experienced a decrease, and 4 experienced no change.
The initial mean angle of deviation was 26.23± 7.97 PD at near
fixation and 24.73±8 PD at distance fixation which was corrected by
glasses to 2.80±1.35 PD at near fixation and 1.70±1.32 PD at distance
fixation.
Binocular single vision was tested at the most recent
examination and 90% of the patients had fusion with Worth 4-dot test.
Stereopsis was tested by Titmus fly test and 38 (63.33%) had
stereopsis ranging from 40 to 100 Sec/arc and 22(36.67%) had
between 100 and 200 Sec/arc.
As regard factors affecting stereopsis, it was found that higher
levels of stereopsis were found in those children who presented later
but these factors were not statistically significant.
Amblyopic patients rate reduced from 50% to 16.67% between
initial and final visit. Possible risk factors involving the development
of amblyopia was analyzed and found that anisometropia was the only
statistically significant risk factor for the development of amblyopia
among the studied patients.