Surgical management of a patient with exercise-induced esotropia.

Exercise-induced esotropia is a rare form of strabismus characterized by paroxysms of esotropia and diplopia only during exercise. This report describes a 15-year-old boy who presented with a 1-year history of exercise-induced esotropia. He has been asymptomatic after recession of a single medial rectus muscle. It is hypothesized that the esotropia was attributable to a malfunction in the muscle tension-control circuit and that altering the small signal gain with surgery resulted in improvement.