The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses.
- Author:
Wook Kyum KIM
1
;
Sung Yong KANG
;
Soolienah RHIU
;
Seung Ah CHUNG
;
Jong Bok LEE
Author Information
- Publication Type:Original Article
- Keywords: Accommodation; Convergence; Esotropia
- MeSH: Accommodation, Ocular/*physiology; Adolescent; Child; Cyclopentolate/administration & dosage; Esotropia/*physiopathology/*therapy; *Eyeglasses; Female; Humans; Male; Phenylephrine/administration & dosage; Retrospective Studies; Statistics, Nonparametric; Tropicamide/administration & dosage
- From:Korean Journal of Ophthalmology 2012;26(1):39-44
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To report the long term results of bifocal treatment in nonrefractive accommodative esotropia and to analyze the changes of accommodative convergence to accommodation (AC/A) ratio. METHODS: Sixteen patients treated with bifocal glasses for at least 5 years were evaluated retrospectively. Angle of deviation at near and distance, refractive error, and AC/A ratio by the lens gradient method were analyzed. The changes of AC/A ratios were also compared after dividing the patients according to continuation or cessation of bifocal therapy. RESULTS: Six patients (38%; bifocal stop group, BSG) were able to stop using bifocal glasses at an average age of 10.8 years (range, 6.5 to 15.4 years) during their follow-up. However, the other ten patients (62%; bifocal continue group, BCG) had to continue using bifocal glasses until the final visit, which was 13.8 years on average (range, 11.3 to 18.5 years). The AC/A ratio decreased from time of bifocal prescription to the last visit in both groups, from 4.4 to 2.7 in the BSG and from 5.9 to 4.5 in the BCG. AC/A ratios were significantly higher (p = 0.03) in the BCG than that of the BSG from the beginning of bifocal treatment and this difference was persistent until the final visit (p = 0.03). CONCLUSIONS: The AC/A ratio decreased with age in both groups but was significantly higher throughout the entire follow-up period in the BCG. AC/A ratio at bifocal prescription could be an important factor in predicting response to bifocal treatment.
