Longitudinal changes in refractive error of children with infantile esotropia.

AIM

the aim of this study was to quantify changes in refractive status over time in children with infantile esotropia (ET) and to analyse a number of clinical factors associated with infantile ET to determine how they may affect emmetropisation.

METHODS

longitudinal cycloplegic refraction data were collected for 5-12 years from 143 consecutive children enroled in a prospective study of infantile ET by 6 months of age. Changes in refractive error with age were summarised with descriptive statistics and the influence of amblyopia, undercorrection of hypermetropia, accommodation, and binocular factors on emmetropisation were evaluated by analysis of variance and t-tests.

RESULTS

most had low to moderate hypermetropia on the initial visit (55% had <+3.00 D). Although the initial refractive error is similar to normative data, the rapid decrease in hypermetropia that characterises normal development during the first 9 months of life is absent in children with infantile ET. After 9 months of age, children with infantile ET follow a developmental course, which is similar to the normative course; there is little change in hypermetropia during years 1-7, followed by a decline of approximately -0.5 D/year beginning at age 8 years. None of the clinical factors examined had a statistically significant effect on the course of refractive changes with age.

CONCLUSION

children with infantile ET exhibit a different pattern of refractive development than that seen in normative cohorts. The long-term changes in refraction observed in children with infantile ET suggest that there is a need for long-term clinical follow-up of these children.