title: The efficacy of SimulVue and Unilens RGP aspheric bifocal contact lenses in the treatment of esotropia associated with a high accommodative convergence/accommodation ratio.
abstract: OBJECTIVE
  This was a prospective study assessing the efficacy of the SimulVue bifocal contact lens and the Unilens RGP aspheric multifocal contact lens (Unilens, Largo, Fla.) in the treatment of high accommodative convergence/accommodation (AC/A) esotropia in an adolescent and postadolescent population.
  
  
  METHODS
  Those patients meeting the inclusion criteria were fit with contact lenses with use of full cycloplegic refraction and later retested by an examiner masked to the previous binocular status. Particular attention was given to the sensory status and the motor fusion of each patient in their bifocal spectacles and then in their bifocal contact lenses. All patients were followed up for at least 6 months after the contact lenses were fitted.
  
  
  RESULTS
  Five of the six patients demonstrated larger angles of esophoria or tropia at near with the contact lenses than with bifocal spectacles. The only patient who maintained excellent stereopsis in bifocal contact lenses was the one who normalized her AC/A ratio during this study and no longer required a bifocal in her spectacle correction for fusion. The two patients who initially had no stereopsis but good alignment in spectacle correction had a large esotropia at near fixation with bifocal contact lenses.
  
  
  CONCLUSIONS
  The SimulVue and Unilens RGP aspheric bifocal contact lenses did not adequately treat adolescent patients who had esotropia associated with a high AC/A ratio.
authors.affiliation: Department of Ophthalmology and Visual Sciences, the University of Wisconsin, Madison, USA.
authors.forename: G V
authors.initials: GV
authors.lastname: Morton
authors.forename: B J
authors.initials: BJ
authors.lastname: Kushner
authors.forename: N J
authors.initials: NJ
authors.lastname: Lucchese
authors.forename: M B
authors.initials: MB
authors.lastname: Shapiro
authors.forename: D C
authors.initials: DC
authors.lastname: Bredeson
mesh_terms: D000065:Accommodation, Ocular; D000293:Adolescent; D002648:Child; D003261:Contact Lenses / Q000592:standards*; D003290:Convergence, Ocular; D003867:Depth Perception; D004867:Equipment Design; D004948:Esotropia / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D011446:Prospective Studies; D017211:Treatment Failure