Usefulness of Cycloplegic Refraction with Atropine in Patients with Partially Accommodative Esotropia

Abstract

Purpose: To investigate the usefulness of atropine (Isopto atropine 1% eye drops®; Alcon, Fort Worth, TX, USA) for cycloplegic refraction in patients with partially accommodative esotropia.Methods: We retrospectively analyzed the medical records of patients with partially accommodative esotropia who underwent cycloplegic refraction using both cyclopentolate and atropine at Pusan National University Hospital between November 2017 and December 2020. Patients who replaced their glasses after cycloplegic refraction with atropine were included in group 1 and all other patients were included in group 2. Clinical features and the angle of ocular deviation were compared between the two groups.Results: This study included 23 patients with a mean age of 58.2 ± 22.3 months and mean interval between the two examinations of 5.2 ± 4.1 months. Spherical equivalent was larger after cycloplegic refraction using atropine compared to cyclopentolate (+3.04 ± 1.70 and +2.31 ± 1.75 diopters, respectively; p = 0.001). Groups 1 and 2 included 19 (83%) and 4 (17%) patients, respectively. Clinical characteristics did not significantly differ between the two groups. In group 1, the angle of ocular deviation at near fixation significantly decreased from 28.7 ± 14.0 to 20.7 ± 11.6 prism diopters (p = 0.002) after correction of the refractive error.Conclusions: Cycloplegic refraction with atropine may be useful for detecting latent hyperopia and managing strabismus in patients with partially accommodative esotropia.