Peculiarities of accommodative esotropia

Abstract Purpose To study the visual functions and the state of accommodation–convergence–papillary system (ACPS) in children with different forms of accommodative esotropia(AE) Methods Except of the standard ophthalmological examination the pupillography was performed in 88 patients aged 6‐18 years with refractive AE (45), nonrefractive AE (31), combinated AE (12) Results Results, with optical correction the visual acuity below 0,3 took place of 55,8±7,6% patients with refractive AE, 42,0±18,7% cases with combinated AE, 33,3±9,1% children with nonrefractive AE. Convergence was normal in all cases of refractive and nonrefractive AE, but was weak in 42,8±18,7% patients with combinated AE. Fusion in haploscopic condition was absent in 65,1±7,3% cases of refractive AE, 51,9±9,6% patients with nonrefractive AE and in all cases of combinated AE. Worth´s four dot test showed monocular vision in 88,4±4,9% cases of refractive AE, 85,1±13,2% of combinated AE and 66,7±17,1% of nonrefractive AE. Accommodative insufficiency was inherent to all patients. Pupillography showed narrowing of pupils in all patients in comparison with healthy children. Pupil reaction to light was weakened considerably. The latent periods of the direct, consensual pupillary reaction to light and the latent periods of pupillary reaction after light stimulation and after convergences weakening were increased more than three times as in healthy children. Conclusion Besides the already known differences in the state of refraction and the value of index AC/A, the These types of AE differ from each other in such functions as visual acuity, fusion power, binocular vision, convergence. Disturbances of pupillary reactions indicate on reduction of lability, increase ACPS’s passivity due to functional changes in brainstem.