To report clinical aspects of children diagnosed with refractive accommodative esotropia after wearing their first glasses to correct hyperopia accompanied with esodeviation.

The present study included 75 children followed up for at least 24 months. Age, spherical equivalent of refractive error, angle of deviation and presence of amblyopia were analyzed according to the duration between first wearing glasses and control of esotropia within 8 PD (≤2 months vs. >2 months).

The mean age was 4.48 ± 2.08 years and mean follow-up was 50.17 months. Initial deviation angle without glasses was 25.43 ± 10.07 PD at far, 27.72 ± 11.45 PD at near, spherical equivalent was +4.86 ± 2.41 D in right eyes, +5.05 ± 1.06 D in left eyes and 8 of 75 patients (10.67%) had ≤2 D of hyperopia. Esotropia was controlled within 8 PD with hyperopic glasses in 61 of 75 children (81.3%) within 2 months, 6 (8%) within 3-6 months, 4 (5.3%) within 6-12 months and 4 (5.3%) after 12 months. In comparison, esotropia was controlled ≤2 months in 61 of 75 children (81.3%); 14 of 75 children (18.7%) requiring >2 months had less hyperopia (+4.02 D vs. 5.17 D), more severe esodeviation both at far (30.79 ± 10.79 PD vs. 24.17 ± 9.56 PD, p = 0.03) and at near distance (34.00 ± 14.20 PD vs. 26.25 ± 10.31 PD, p = 0.02) and higher initial amblyopia prevalence rates (71.5% vs. 47.5%).

Several patients needed longer follow-up until esotropia was controlled within 8 PD after wearing hyperopic glasses considering the amount of hyperopia and angle of esodeviation.