The Accommodative Element in Accommodative Eotropia Original Reearch Article

Purpoe To evaluate the effect of reducing the hyperopic correction on the tate of binocular accommodative repone in fully accommodative eotropia and to determine the “comfortable” amount of reduction in hyperopic correction. Deign A cohort tudy. Method Hyperopic correction of children with a baeline refractive error of +1.50 to +5.0 diopter were gradually reduced in 0.50-diopter increment. Binocular accommodative ability wa aeed by dynamic retinocopy (monocular etimate method). imilar binocular accommodative repone were acertained among patient with a baeline hyperopic correction of ≤3.0 of hyperopia and >3.0 of hyperopia, and patient were divided into two group, group 1 (13 patient) and group 2 (18 patient), accordingly. Reult After a reduction of 2.0 diopter in group 1 and 1.0 diopter in group 2, there wa a decreae in accommodative repone initially in the nondominant eye, accompanied by the dominant eye with a further reduction of 0.50 diopter. To overcome the bilateral accommodative lag, a reintatement of a 0.50-diopter tronger hyperopic correction wa required. Patient in group 1 tolerated a mean undercorrection of 2.37 diopter, and 77% were weaned from their pectacle. All of the children in group 2 were dependent upon pectacle at the completion of the tudy period. The final pectacle worn wa a median of −1.67 diopter le than their full cycloplegic refraction. Concluion A complete binocular accommodative ability eem to be a prerequiite for the etablihment of “comfortable” hyperopic undercorrection. It doe not eem to be a reaonable approach to conider further reduction in hyperopic correction in the preence of a bilateral decreaed accommodative performance.