title: The maximal tolerable reduction in hyperopic correction in patients with refractive accommodative esotropia: a 6-month follow-up study.
abstract: OBJECTIVE
  To investigate the optimal amount of safe under-correction in patients with refractive accommodative esotropia.
  
  
  METHODS
  Prospective noncomparative interventional case series.
  
  
  METHODS
  Patients with refractive accommodative esotropia wore trial glasses based on cycloplegic refraction, then -0.25 diopters (D) of minus sphere lenses were placed on both lenses of the trial glasses and the deviation was measured. Minus spheres of -0.25 D were continuously added until the angle of deviation increased; the minus spheres added just before the deviation increase were defined as the maximal tolerable amount of under-correction. A total of 38 patients were prescribed under-corrected spectacles up to -1.5 D and followed for 6 months.
  
  
  RESULTS
  Thirty-one patients underwent the maximal tolerable amount of under-correction and 7 underwent -1.5 D of under-correction. A mean -0.89 D of under-correction was performed. We observed no deterioration in visual acuity, stereoacuity, or fusional ability during the follow-up period in any of the patients. Small increase in the angle of deviation of 2 prism diopters was noted in 2 patients. The mean spherical equivalent refractive error of both eyes (P = .012) and age of onset (P = .006) showed strong positive correlations with the maximal tolerable amount of under-correction.
  
  
  CONCLUSIONS
  A reduction in hyperopic correction by the maximal tolerable amount of under-correction was performed without notable short-term side effects. The spherical equivalent refractive error and age of onset appear to be useful clinical indices in determining the appropriate amount of under-correction.
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Park
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Sei Yeul
authors.initials: SY
authors.lastname: Oh
mesh_terms: D000065:Accommodation, Ocular; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000628:therapy*; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D042262:Retinoscopy; D014792:Visual Acuity / Q000502:physiology