Longitudinal development of ocular biometric components and refractive error in hyperopic children with infantile versus late‐onset accommodative esotropia

Abstract Purpose To examine the developmental patterns of refractive error and optical components in hyperopic children with infantile (onset ≤12 months of age) accommodative or late‐onset (18–48 months of age) accommodative esotropia. Methods This prospective longitudinal study included children with infantile ( n = 34) or late‐onset ( n = 63) accommodative esotropia. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and keratometry (K1, K2) were obtained with a Lenstar LS 900. Lenstar measures were recorded <6 months after cycloplegic spherical equivalent refraction (SER) was derived. An initial examination was conducted at 5.8 ± 1.5 years of age, with a follow‐up duration of 4.8 ± 0.8 years. A linear mixed‐effects model was used to estimate the rate of individual development for each ocular component and SER, and to compare the two groups. Results All biometric components changed with age. The rates of change with age for SER and AL were significantly different between the infantile and late‐onset groups (SER: −0.18 vs. −0.12D/year, p < 0.001; AL: 0.16 vs. 0.14 mm/year, p < 0.01). The rate of change with age of the AL/CR ratio was significantly different between the infantile and late‐onset groups (0.019 vs. 0.016, p < 0.001). No significant differences in the rates of change in ACD, LT, K1 or K2 were identified. Conclusions Major ocular biometric components in children continue to mature in both infantile and late‐onset accommodative esotropia. Annual change in axial length is smaller in late‐onset accommodative esotropia than for infantile accommodative esotropia, consistent with less change in the SER with age.