Clinical study of esodeviations in children

Esotropia or convergent strabismus is a common type of squint in children. The esodeviation, the refractive error and the amblyopia should be examined and treated early to achieve good cosmetic correction and to improve Visual acuity. A meticulous history of 25 children up to age of 12 years who presented with esodeviations was taken including the age of onset, duration and previous treatment. They were examined for amount and type of deviation by cover test, hirschberg corneal reflex test, Prism bar cover test and evaluated for refractive error under full cycloplegic correction, for Binocular Single Vision, diplopia, suppression and amblyopia by Worth four-dot test and RAF ruler. Ocular movements and fundus findings were recorded. 11 male and 14 female children with esodeviations with age of presentation varying from 9 months to 12 years were evaluated for type of esotropia. In our study the most common type seen in 12 cases (48%) is refractive accommodative esotropia with high hypermetropia. Non-refractive accommodative esotropia greater for near with high AC/A ratio in 5 patients (20%), Partially accommodative (mixed) esotropia in 2 cases, acquired non-accommodative esotropia seen in 2 patients. 1 case each is seen in Infantile esotropia, in Sensory esotropia, in child with Duane’s retraction syndrome (DRS) and in child having cerebral visual impairment (CVI). Our study aimed to diagnose and manage the various types of esodeviations at an early age so as to maintain binocular alignment and a good Visual acuity to avoid progression to amblyopia.