Optical correction principles of accommodative esotropia

Accommodative esotropia is the most common type of esotropia in children. The patients often need to wear hyperopic glasses to correct eye positions and improve vision and binocular function. However, the course of accommodative esotropia is usually long, so it is necessary to monitor the refractive changes for a long time. Maintaining full hyperopic correction will interfere with the emmetropia development of the eyeball, and undercorrection of hyperopia will lead to the risk of esotropia decompensation. These often bring confusion when clinicians prescribe glasses. The benefits of accommodative esotropia with a high accommodation convergence/accommodation ratio from fitting bifocal lenses and the effect of prisms on residual esotropia have also been controversial topics in this field. In this article, we combine the research status and clinical practice to present some points of view for the peer reference. (Chin J Ophthalmol, 2021, 57: 331-335).