To analyze clinical characteristics of refractive accommodative esotropia related with the occurrence of decompensation and cessation of spectacle use.

The records of 60 patients with refractive accommodative esotropia were reviewed. Patients were divided into a control or decompensation group. Twenty-nine patients in the control group who were followed up for long-term were divided into two groups based on spectacle use.

In the decompensation group, the amounts of near and distant esodeviation without correction at the first visit and the frequency of failure to achieve central fusion were significantly greater than the control group ( p < 0.05). Ages at the onset of esodeviation and first visit, the amount of hyperopia at the first visit, the amounts of controlled esodeviation, amblyopia, and anisometropia were not significantly different between the two groups ( p > 0.05). In the group that no longer required glasses, the age at the first visit was greater and the amount of hyperopia and the near and distant esodeviations without correction at the first visit were significantly greater than the glasses-wearing group ( p < 0.05). Age at the onset of esodeviation, the amount of controlled esodeviation, refractive change per year, stereopsis, amblyopia, and anisometropia were not significantly different between the two groups ( p > 0.05).

In refractive accommodative esotropia, a larger amount of esodeviation at the first visit and failure to achieve central fusion are risk factors for developing decompensation. The older age at diagnosis and smaller amounts of hyperopia and esodeviation at the first visit are predictive factors for the cessation of spectacle use.