To analyze the long-term clinical features and functional outcomes of refractive accommodative esotropia.

Initial and final age, cycloplegic refraction, distance and near deviation with and without correction, stereoacuity and incidence of amblyopia were evaluated in 45 patients with accommodative esotropia.

The follow-up duration was 65.77±43.98 (6~151) months, and the mean age was 4.02±1.97 and 9.42±3.77 years at the first and final visits, respectively. The cycloplegic refraction was decreased from 5.16±1.92 diopters (D) to 4.41±1.83D, averaging -0.09±0.40D annually ( P <0.01). Of these hyperopic eyes, 55 (61.1%) experienced a decrease, 22 (24.4%) an increase, and 5 (5.6%) showed no changes. From 5 (31.2%) to 12 (75.0%) of 16 patients had a stereoacuity of 100 sec/arc or better ( p <0.01). Fusion was achieved in 14 (87.5%) at the final visit, up from 11 (68.8%) at the first visit ( P =0.39); 23 (51.1%) of the patients were amblyopic; and anisometropia was found in 9 (39.1%) patients.

Patients whose esotropia was corrected with full cycloplegic hyperopic correction show decreased longitudinal changes in spherical equivalent refractive error with a time course and have excellent binocularity outcomes.