Accommodative esotropia is one of the most common types of strabismus in childhood

Accommodative esotropia is one of the most common types of strabismus in childhood. The incidence is estimated at 2% of the population. It is usually found in patients with moderate amounts of hyperopia. As the patient accommodates or focuses the eyes, the eyes converge. The over-convergence associated with the accommodation to overcome a hyperopic refractive error can cause a loss of binocular control and lead to the development of esotropia.

Accommodative esotropia is caused by accommodative convergence associated with hyperopia. As infants, the eyes are straight, but as they learn to accommodate to see clearly, the fusional divergence is not adequate and the child develops esotropia.

Risk factors.

•Hyperopia (usually greater than +2.00).

•Family History, although no pattern of inheritance or genetic locus has been identified.

•May be preceded by illness or trauma; the illness or trauma doesn’t cause the disorder, but can precipitate its manifestation.

•Symptoms can recur around the time of onset of presbyopia.