A 3-year-old child is diagnosed with esotropia measuring 35 prism diopters. Cycloplegic refraction shows +4.0 D OU. After full hyperopic correction for 3 months, residual esotropia is 10 prism diopters. This residual deviation represents:

• A Partially accommodative esotropia — residual non-accommodative component requiring surgery ✓
• B Accommodative esotropia — fully corrected by glasses
• C Basic esotropia — glasses have no effect
• D Consecutive esotropia

Explanation

When hyperopic spectacle correction reduces but does not fully eliminate esotropia, the condition is classified as partially accommodative esotropia. The accommodative component (25 PD here) is controlled by glasses, but the residual non-accommodative component (10 PD) requires surgical correction (recession-resection or bilateral medial rectus recession). Fully accommodative esotropia resolves completely with full hyperopic correction. Basic esotropia is unaffected by glasses (no refractive error relationship). Consecutive esotropia is over-correction after exotropia surgery.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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