Prisms, Vision Therapy Reduce AACE - Summary - MDSpire

Prisms, Vision Therapy Reduce AACE

Retrospective cohort shows 79% of patients improved without surgery, with measurable gains in divergence and reduced esodeviation

  • By

  • Julie Greenbaum

  • March 5, 2026

  • 4 min

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Objective:

To evaluate the effectiveness of non-surgical management using prisms and vision therapy in patients with acute acquired comitant esotropia (AACE).

Key Findings:
  • 79% of patients showed improvement in divergence amplitudes and reduction in esodeviation.
  • Median distance esodeviation decreased by about 7 prism diopters and near deviation by about 6 prism diopters after therapy.
  • Divergence amplitudes improved by about 7 PD at distance and 8 PD at near.
  • No patient reported diplopia after therapy.
  • 14 patients were included in the analysis.
Interpretation:

Non-surgical management with prisms and vision therapy is effective for most patients with non-accommodative AACE, significantly improving both divergence and esodeviation.

Limitations:
  • Retrospective design and incomplete documentation for some variables.
  • Heterogeneity in therapy modality and duration.
  • Lack of a control group and assessment of natural disease progression in untreated patients, which may affect the generalizability of the results.
Conclusion:

Non-accommodative, non-neurologic types of AACE can be effectively managed non-surgically in 79% of patients, improving divergence and reducing esodeviation, highlighting the importance of these management options.

Original Source(s)

Prisms, Vision Therapy Reduce AACE

  • by Julie Greenbaum

  • March 5, 2026

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