ABSTRACT
Current understanding of accommodative esotropia holds that uncorrected hypermetropia, abnormal AC/A ratio, and/or a poor motor fusion are three major factors in the etiology of this condition. Usually, accommodative esotropia has been classified as a subgroup of acquired esotropia, that is with an age of onset after six months of age. The strict division between infantile esotropia and accommodative esotropia has been questioned, and the term “early-onset accommodative esotropia” has been used to define a group of children with strabismus onset before six months of age, but with the features of refractive esotropia of normal alignment with optical correction. However, there seems to be some controversy regarding the binocular potential, both in accommodative esotropia in general, and in the early-onset accommodative esotropia group in particular. Hypoaccommodation is probably an import etiological factor in some patients with refractive or non-refractive accommodative esotropia, especially individuals with Down syndrome.
