Psychophysiology of Refractive Accommodative Esotropia

Purpose. To investigate the psychophysiologic aspects of refractive accommodative esotropia (RAE). Methods. I prospectively recruited patients aged 3-6 years with more than 3.0 diopters of hyperopia who presented at Kim's Eye Hospital from January 2011 to March 2013. I compared Korean Child Behavior Checklist (K-CBCL) which consists of internalizing factors (social withdrawal, somatic complaints, anxiety, and depression) and externalizing factors (social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior) between RAE group and control group. Results. Two out of three internalizing indexes were significantly different between groups (somatic complaints: RAE children 50.1 ± 4.6 and controls 46.6 ± 5.8, P = 0.026; depression/anxiety: RAE children 48.8 ± 7.9 and controls 43.9 ± 6.8, P = 0.024). Although there was no significant difference, RAE children scored slightly higher on the externalizing behavior index. In the RAE group, the far angle of esodeviation showed a moderate correlation with withdrawn behaviors. Conclusion. Hypermetropic children with high scores on the somatic complaint and depression/anxiety subscales of the CBCL could be at high risk for developing RAE. Psychosocial problems might be related to the pathogenesis of refractive accommodative esotropia.