Characteristics of infantile esotropia following early bimedial rectus recession.

A homogeneous group of infantile esotropes were studied who underwent surgical alignment before 1 year of age. Three groups emerged: those who remained stable following their initial early alignment, those who were well aligned and remained stable for prolonged periods of time and then decompensated, and those who were unstable throughout the observation period. Preoperatively, no factors were identified that predicted into which group each patient might enter. Other associated factors were identified that affected the strabismic angle and these were overactions of the inferior oblique muscles, dissociative vertical deviation, rotary and other forms of nystagmus, amblyopia, and changing refractive errors. The treatment modalities consisted of miotics, glasses, bifocals, occlusion, and repeated operations. This study underscores the instability of the conditions of patients with infantile esotropia and the need for repeated observations throughout the first decade of life.