Intermittent XXXX with high AC/A ratio: is it a bane to surgical cure? Some facts and fictions of the two clinical tests: occlusion of one eye and the use of +3.00 spherical lenses.

@entity1 @entity52053 @entity5770 @entity1112 @entity5971
BACKGROUND AND PURPOSE: To review the multiple factors in intermittent @entity5770 (X(T)) responsible for the discrepancy between the distance and near deviations; to challenge the classification of X(T) into types according to the two standard clinical tests of occlusion of one eye and the use of +3.00 D spherical lenses at near by demonstrating the pitfalls of these two tests, as in X(T), masquerading as high AC/A ratio at times or as strong proximal fusional convergence at other times. METHODS OF STUDY: Fifteen @entity1 demonstrating findings characteristic of X(T) with so-called high AC/A ratio are reported. Fourteen @entity1 had an @entity5770 initially. The fifteenth had become exotropic following medial rectus recessions for infantile @entity5971 . Fourteen @entity1 had bilateral lateral rectus recession and one had unilateral lateral rectus recession. RESULTS: The only @entity1 who did develop a long term postoperative overcorrected high AC/A ratio @entity5971 was the @entity1 who had initially an infantile @entity5971 . Of the other 14 @entity1 @entity1112 (T) none developed a long term postoperative overcorrected high AC/A ratio @entity5971 . Fifty % of these were "cured" (OT +/- @entity52053 ) and 50% had a "significant (> or = @entity52053 ) recurrence" of their @entity5770 . CONCLUSION: @entity1 with intermittent @entity5770 and significantly more @entity5770 at distance than at near, and classified to have high AC/A ratio by occlusion of one eye and the use of +3.00 spheres at near, do not necessarily have a high accommodation-convergence relationship but rather, other factors mimicking this high AC/A relationship. They do not necessarily develop a postoperative overcorrected high AC/A ratio @entity5971 .
