A 6-year-old child has a right esotropia of 30 PD at distance and near. Cycloplegic refraction reveals +4.50 D in both eyes. After full cycloplegic correction, the esotropia reduces to 10 PD. The residual deviation of 10 PD is non-accommodative. What type of esotropia is this?

• A Partially accommodative esotropia ✓
• B Fully accommodative esotropia
• C Infantile esotropia
• D Divergence insufficiency

Explanation

Accommodative esotropia is caused by excess convergence driven by accommodative effort. When full hyperopic correction reduces but does not eliminate the deviation, the remaining non-accommodative component is present — this is classified as partially accommodative esotropia. Full optical correction is given for the accommodative component; surgical correction (medial rectus recession) is performed for the residual non-accommodative component. Fully accommodative esotropia shows complete correction with glasses.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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