{"id":15156,"date":"2021-07-11T13:47:25","date_gmt":"2021-07-11T13:47:25","guid":{"rendered":"https:\/\/www.optometrists.org\/?page_id=15156"},"modified":"2021-07-15T07:16:35","modified_gmt":"2021-07-15T07:16:35","slug":"accommodative-esotropia-real-pateints","status":"publish","type":"page","link":"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/accommodative-esotropia-real-pateints\/","title":{"rendered":"Accommodative Esotropia: Real Patients"},"content":{"rendered":"<h2><b>Accommodative esotropia usually presents itself in children from age 2 and older.<\/b><\/h2>\n<p>The most prevalent type of<a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/\"> childhood strabismus (eye turn)<\/a> is accommodative esotropia. As with every strabismus, it results from a mismatch between stimuli that increase the need for fusion and factors that govern the quality of fusion.<\/p>\n<p>Below are 3 case studies that highlight important aspects of clinical care of accommodative esotropia.<\/p>\n<p>*Names have been changed for protection of privacy.<\/p>\n<h2>Case study #1: <b>Bella, Age 5<\/b><\/h2>\n<h3><b>Complaint<\/b><\/h3>\n<p>Turned eye and poor performance at school.<\/p>\n<h3><b>Findings\/Diagnosis<\/b><\/h3>\n<p>Esotropia caused by long-sightedness.<\/p>\n<p>Bella\u2019s optical prescription was found to be R and L +4.00\/-0.50\u00d7180. This is a very high level of long-sightedness.<\/p>\n<p>She was diagnosed with accommodative esotropia.<\/p>\n<h3><b>Treatment<\/b><\/h3>\n<p>Bella was prescribed glasses with a prescription giving her 20\/25 vision. After wearing the new glasses for five weeks, the large constant eye turn was reduced to a small eye turn, only she was reading.<\/p>\n<p>This helped confirm that she had accommodative esotropia. She was advised to continue to wear her\u00a0 glasses continually.<\/p>\n<p>One year after the initial presentation, Bella was able to achieve 20\/20 vision in both eyes with her glasses.<\/p>\n<h3><b>Outcome<\/b><\/h3>\n<p><b>Bella\u2019s academic performance significantly improved after she started wearing her eyeglasses.<\/b><\/p>\n<p>Having clear and comfortable vision appears to have facilitated Bella\u2019s reading, which is now fluent and enjoyable for her, and has improved\u00a0 her academic performance.<\/p>\n<p>If your child is struggling in school, it could be their vision,<a href=\"https:\/\/www.optometrists.org\/practice-search\/\"> <strong>c<\/strong><b>ontact an eye doctor near you <\/b><\/a>who can evaluate your child\u2019s vision.<\/p>\n<p><strong>SEE RELATED:<\/strong> <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/what-is-accommodative-esotropia\/\">What is Accommodative Esotropia?<\/a><\/p>\n\n\t<div class=\"practice-search-widget\">\n\t\t<h3>Find an eye doctor near you<\/h3>\n\t\t\n\t<form class=\"practice-search-form practice-search-form-widget\" action=\"https:\/\/www.optometrists.org\/practice-search\/results\/\" method=\"get\">\n\n\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\t\t<input type=\"hidden\" name=\"page\" class=\"practice-search-page\">\n\t\t<input type=\"hidden\" name=\"address_latitude\"><input type=\"hidden\" name=\"address_longitude\">\n\n\t\t<input type=\"text\" name=\"address\" class=\"practice-search-address\" placeholder=\"City, Surburb or Address\" value=\"\">\n\n\t\t\n\t\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\n\t\t\n\n\t\t<button type=\"submit\" class=\"practice-search-button\">\n\t\t\t\t\t\t\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M10.6796 0.130005C9.15708 0.130059 7.66615 0.5646 6.38198 1.38258C5.09781 2.20057 4.07373 3.36803 3.43004 4.74783C2.78634 6.12763 2.54976 7.66246 2.74808 9.17205C2.9464 10.6816 3.57139 12.1033 4.54964 13.27L0.729639 17.08C0.6364 17.1732 0.562439 17.2839 0.511979 17.4058C0.461519 17.5276 0.435547 17.6581 0.435547 17.79C0.435547 17.9219 0.461519 18.0524 0.511979 18.1743C0.562439 18.2961 0.6364 18.4068 0.729639 18.5C0.917942 18.6883 1.17334 18.7941 1.43964 18.7941C1.5715 18.7941 1.70207 18.7681 1.82389 18.7177C1.94571 18.6672 2.0564 18.5932 2.14964 18.5L5.99964 14.62C7.35406 15.6038 8.98566 16.1324 10.6596 16.13C12.7814 16.13 14.8162 15.2871 16.3165 13.7869C17.8168 12.2866 18.6596 10.2517 18.6596 8.13C18.6596 6.00827 17.8168 3.97344 16.3165 2.47315C14.8162 0.97286 12.7814 0.130005 10.6596 0.130005H10.6796ZM10.6796 14.13C9.49295 14.13 8.33291 13.7781 7.34622 13.1188C6.35952 12.4595 5.59049 11.5225 5.13636 10.4261C4.68224 9.32975 4.56342 8.12335 4.79493 6.95946C5.02644 5.79558 5.59788 4.72648 6.437 3.88736C7.27611 3.04825 8.34521 2.4768 9.5091 2.24529C10.673 2.01378 11.8794 2.1326 12.9757 2.58673C14.0721 3.04085 15.0092 3.80989 15.6685 4.79658C16.3277 5.78328 16.6796 6.94332 16.6796 8.13C16.6796 9.7213 16.0475 11.2474 14.9223 12.3726C13.7971 13.4979 12.2709 14.13 10.6796 14.13Z\" fill=\"#fff\"\/><\/svg>\n\t\t\t\t\t<\/button>\n\n\t\t<button type=\"button\" class=\"practice-search-use-my-location\">\n\t\t\tSearch near me\n\t\t<\/button>\n\n\n\t<\/form>\n\n\n\n\t\t<\/div>\n\n\t\n<h2><b>Case study #2: Cynthia, Age 3<\/b><\/h2>\n<h3><b>Complaint<\/b><\/h3>\n<p>Constant \u2018inward turn\u2019 of the right eye<\/p>\n<h3><b>Findings\/Diagnosis<\/b><\/h3>\n<p>Accommodative esotropia with lazy eye (amblyopia).<\/p>\n<p>Her prescription was found to be R +5.00\/-1.00\u00d7180, L +4.00\/-0.50\u00d7180, however her vision in the right eye was lower than the left, being 20\/200 as compared to 20\/40.<\/p>\n<p><b>Cynthia had significant hypermetropia and a lazy eye.<\/b><\/p>\n<p>She was prescribed lenses as the diagnosis was partial accommodative esotropia with amblyopia.<\/p>\n<h3><b>Treatment<\/b><\/h3>\n<p>After two months with corrective lenses, Cynthia\u2019s vision in her left eye improved from 20\/40 to 20\/25.<\/p>\n<p>Three months after wearing glasses, Cynthia returned. While her parents did not notice the eye turn as much, they did notice she was tired. Cynthia was instructed to wear her glasses while all the time wearing a patch over the left eye.<\/p>\n<p>Another four weeks Cynthia\u2019s vision acuity in her lazy eye, her right eye started to improve from 20\/200 to 20\/60.<\/p>\n<h3><b>Outcome<\/b><\/h3>\n<p><b>Cynthia\u2019s parents felt that her eyes looked straight when she wore her glasses.\u00a0<\/b><\/p>\n<p>Cynthia needed to continue to wear glasses full-time, with patching of the left eye.<\/p>\n<p>Over the course of five more monthly reviews, Cynthia continued to wear essentially the same lens correction. Her therapy for amblyopia was modified twice:<\/p>\n<p>First, patching for two hours per day of the non-amblyopic eye to one hour of concentrated near work. Later, atropine drops were added to the therapy program of the non-amblyopic eye, as periodically changing therapy is useful.<\/p>\n<p>At her last review her visual acuity in the right eye 20\/25 and she started to see 3D. Due to treatment for lazy eye, gross stereopsis (3D) vision was slowly improving.<\/p>\n<h2><b>Case study #3: Wilson, age 4<\/b><\/h2>\n<h3><b>Complaint<\/b><\/h3>\n<p>Presented \u2018crossed-eyes\u2019 that \u2018swapped from right to left\u2019.<\/p>\n<h3><b>Findings\/Diagnosis<\/b><\/h3>\n<p>Reaction test showed a prescription of\u00a0 R +2.50 DS and L+2.50 DS, and that his visual acuities in both eyes were 20\/30.<\/p>\n<p>He was found to have significant hypermetropia (long-sighted).<\/p>\n<p>Prescription lenses of +2.50 in both eyes were prescribed for full-time wear.<\/p>\n<h3><b>Treatment<\/b><\/h3>\n<p>Wilson returned two months later. His parents felt that the \u2018eye turn\u2019 had disappeared with the glasses but was unchanged without them.<\/p>\n<p>Vision was 20\/20 in both eyes, but his eye still turned when reading.<\/p>\n<p>Bifocal glasses were prescribed, the diagnosis was unchanged. Wilson\u2019s optical lenses were changed to +2.50 with a +2.00 near addition in a 35 mm D-segment bifocal.<\/p>\n<h3><b>Outcome<\/b><\/h3>\n<p><b>Wilson returned two months later. His parents were happy with the outcome, as they noticed his eyes did not turn with the glasses.<\/b><\/p>\n<p>His vision was 20\/20 in both eyes and Wilson was advised to continue with the same lenses with six-monthly reviews.<\/p>\n<p><strong>LEARN MORE: <\/strong><a href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/\">Guide To Eye Turns<\/a><\/p>\n<p><a href=\"https:\/\/www.optometrists.org\/practice-search\/\"><b>If you notice your child has an eye turn, contact an eye doctor near you<\/b><\/a> who can treat your accommodative esotropia.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Accommodative esotropia usually presents itself in children from age 2 and older. The most prevalent type of childhood strabismus (eye turn) is accommodative esotropia. As<\/p>\n","protected":false},"author":4,"featured_media":15157,"parent":991,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-article.php","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-15156","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Accommodative Esotropia: Real Patients - Optometrists.org<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.optometrists.org\/childrens-vision\/a-guide-to-eye-turns\/accommodative-esotropia-real-pateints\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Accommodative Esotropia: Real Patients - Optometrists.org\" \/>\n<meta property=\"og:description\" content=\"Accommodative esotropia usually presents itself in children from age 2 and older. 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