Progressive increase in the angle of deviation in congenital esotropia.

The majority of patients with congenital esotropia in this consecutive series of 41 patients showed an increase in the angle of deviation when followed over an average of 3 months. The ages at the initial measurement and surgery, the cycloplegic refraction, and the clinical response to patching could not be used to identify those patients with a progressive increase in the quantity of the deviation. It was found, however, that if the preliminary surgical plan was adjusted (as it was in the majority of the patients in this series) to reflect the latest measurements obtained the day before surgery, a relatively high percentage of patients (90%) could be found to have achieved satisfactory alignment by the 6-week postoperative visit.