Purpose: To discuss the prevalence of deterioration and factors which may influence deterioration .Methods: Records of 137 patients with the diagnosis of refractive accommodative esotropia who were followed for a period of at least 5 years were reviewed.Results: Twenty-three of the 137 patients (16.8%) deteriorated. Deterioration was most likely to occur in patients with a breakdown of the sensory status, or where anti-accommodative therapy was delayed. The age of onset, refractive status, and VA difference between two eyes were not etiologic factors in the process of deterioration.Conclusions: We think that early diagnosis of accommodative esotropia,timely prescription of optical correction and maintenance of binocularity play an important role in preventing deterioration from occurring. Eye Science 1997; 13: 144 - 147. Methods: To discuss the prevalence of deterioration and factors which may may affect deterioration. Methods: Records of 137 patients with the diagnosis of reciprocal refractiveotropinotropia who were followed for a period of at least 5 years were reviewed. Results: Twenty-three of the 137 Patients (16.8%) deteriorated. Deterioration was most likely to occur in patients with a breakdown of the sensory status, or where anti-accommodative therapy was delayed. The age of onset, refractive status, and VA difference between two eyes were not etiologic factors in the process of deterioration. Conclusions: We think that early diagnosis of accommodative esotropia, timely prescription of optical correction and maintenance of binocularity play an important role in preventing deterioration from occurring. Eye Science 1997; 13: 144-147.