A mother brings in her 2 year old child with complaints of intermittent inward crossing of both eyes. You write down in your chart: 30 PD ET and 30 PD ET'. The cycloplegic refraction shows +3.25 D sphere OD and +3.75 D OS. You prescribe the full cycloplegic refraction as treatment for this child. The mother asks you if her child will always have to wear these same-strength glasses. What is the most accurate response to her question?
Accommodation / Vergence / Oculomotor Function
Treatment / Management
The measured hyperopia usually INCREASES until the child is 5 to 7 years old. After this time, the physician may be able to slowly decrease the amount of hyperopic correction in order to stimulate some fusional divergence.
It is important to counsel the parents that glasses will have to be worn for many years to successfully treat accommodative esotropia.