Which is most consistent with accommodative esotropia?
Ans. (b) Onset from infancy to 4 years of ageRef: Kanski 7/e, p. 768-769Option a - feature of Essential infantile esotropia.Option b - most neonates are not accommodating, so the esotropia is acquired when the infant starts to accommodate to bring near objects to focus.As a result of Hypermetropia (2-3 D at birth) in the child, additional accommodative effort is required to bring the images into focus, and thus over convergence response is seen (Near reflex has 3 parts: Accommodation, convergence and miosis).Option c - accommodative esotropia(s) are usually hypermetropic, but rarely more than 7.00 D.If more than that, both eyes become amblyopic without correction.Option d - the binocular potential is normal. Accommodative esotropia is due to an exaggerated near reflex.
Dissociated vertical deviation
Onset from infancy to 4 years of age
Hypermetropia of 8.00 D
Poor to no binocular potential
Strabismus