Document Detail


Do bifocals reduce accommodative amplitude in convergence excess esotropia?
MedLine Citation:
PMID:  20524131     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As therapy with bifocal lenses can generate a condition of acquired hypo-accommodation, we assessed the results of bifocal therapy in children with non-refractive accommodative esotropia in whom near point of accommodation (NPA) was measured before the prescription of the lenses and at the end of the study. METHODS: We examined 28 consecutive patients orthophoric for far, but with esotropia due to excess convergence for near (group 1), and 28 matched controls, orthophoric for far and near (group 2). The patients were prescribed bifocal lenses between the age of 5 and 8. The NPA was measured at time zero and after 4 years of follow-up in both groups. RESULTS: NPA values, measured at time 0, were lower than average (10 dioptres) in ten of the 28 patients in group 1, and increased over the 4 years of follow-up without exceeding 10 dioptres. Only one of the other 18 patients in group 1, with normal NPA, had a lower value at the end of the study, although the values were still above 10 dioptres. CONCLUSIONS: In several patients, excessive convergence is secondary to the extra accommodative effort required due to the presence of a primitive NPA deficit. In these subjects, the prognosis can be made on the basis of NPA measurement, and treatment with bifocal lenses will always be required to compensate. Furthermore, the parents of these small patients should be informed, even before the prescription of bifocals, that prospective surgery of medial rectus muscles will not eliminate the need for bifocals.
Authors:
Michela Fresina; Costantino Schiavi; Emilio C Campos
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-04
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  248     ISSN:  1435-702X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1501-5     Citation Subset:  IM    
Affiliation:
Ophthalmology Service, Department of Surgery and Anaesthesiology, University of Bologna, Bologna, Italy. michela.fresina@libero.it
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MeSH Terms
Descriptor/Qualifier:
Accommodation, Ocular / physiology*
Child
Child, Preschool
Convergence, Ocular / physiology*
Esotropia / physiopathology,  therapy*
Eyeglasses*
Female
Follow-Up Studies
Humans
Male

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