The variable clinical characteristics and course of early infantile esotropia.

A study of 75 patients with early infantile esotropia treated by one of the authors (RMR) between 1965 and 1980 revealed a broad range of clinical findings and treatment modalities. The study group included nine children born prematurely and 16 with neurologic impairment; the balance had no apparent illness other than strabismus. Only 21 patients had spontaneously alternating fixation; the rest required some form of occlusion therapy. Glasses were prescribed for 75% of the patients sometime during their management, and changes in refractive error were common. One or more operations were performed on 56 patients, but 19 patients required no surgical intervention because of a spontaneous decrease in their deviation. Binocularity was found more frequently in patients straightened surgically before 2 years (50%) than in those straightened after that time (14%), but it was also present in five of the 19 patients who required no surgery. The presence of binocularity during the course of treatment did not insure stability of alignment.