Infantile esotropia manifests before a child is 6 months old and includes a constant, large angle of strabismus, no or mild amblyopia, latent. Strabismus is one of the most relevant health problems of the world, and infantile esotropia is perhaps the most visually significant yet the least. The term congenital esotropia is often used interchangeably with infantile esotropia, but few cases are actually noted at birth. Often the exact.

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Historically the term ‘congenital strabismus’ was used to describe constant esotropias with onset between birth and six months of age. Other studies also report better results with early surgery, notably Birch and Stager [23] and Murray et al. This case is an example of a good post-operative outcome with early surgical treatment. Surgery performed prior to 2 years of age has been found to give better visual prognosis.

On the other hand, Chavasse [2] suggested a primary infanyil dysfunction, where the associated poor fusion and lack of high-grade stereopsis is probably a sensory adaptation to abnormal visual stimulation during early binocular development caused by the motor misalignment. Cross-fixation occurs when the patient prefers to fixate with either eye in adduction.

This page was last modified on March 8,at Surgery is performed when any lnfantil amblyopia has been treated and the amount of esotropia is stable.

Krimsky and Hirschberg methods Ductions full OU About 70 prism diopters of esotropia with distance fixation About 70 prism diopters of esotropia with near fixation No palpebral fissure narrowing or globe retraction on evaluation of versions. It is also important to convey that this is a long-term condition that requires continued monitoring for amblyopia and stability in ocular alignment.

Amblyopia treatment is often reserved for those patients with a strong fixation preference. Patients with infantile esotropia frequently have large deviations and are more likely to have residual esotropia following maximum bilateral medial rectus recessions.


Thank you Your feedback has been sent. The natural history of infantile esotropia during the first six months of life.

Usually patients with infantile esotropia have equal visual acuity.

Infantile esotropia – Wikipedia

Alignment within 10 prism diopters of orthotropia often results in the development of a monofixation syndrome. Privacy policy About EyeWiki Disclaimers. Motility was full and ibfantil was no globe retraction—effectively ruling out congenital sixth nerve palsy and Duanes retraction syndrome.

Are other eye alignment problems associated with infantile esotropia? If there is no oblique dysfunction, shifting the medial rectus muscles at time of recession towards the apex of the pattern will weaken the effective pull of the medial rectus at the apex, decreasing the amount of V or A pattern.

The key to a successful ocular examination is efficient and accurate methods of testing vision, motility, and ocular alignment. History jnfantil first presentation aided by photographs of the child in the first few months of life can assist in documenting the onset, detecting the stability of the condition and confirming the diagnosis.

The cause of infantile esotropia has been a topic of great debate for the greater part of the last century. Traditionally, PAT is used in acquired ET to determine the surgical angle and estimate fusion potential.

American Association for Pediatric Ophthalmology and Strabismus

Assessing motility and the child’s ability to abduct the eye can be demonstrated with the “doll’s head” maneuver—also known as vestibular rotation—or by observing motility with one eye occluded ductions. Inferior oblique muscle overaction and dissociated vertical deviation DVD occur in more than half of patients with congenital esotropia.

Infantill and Vision Science Review. Undercorrection and overcorrection are the most commonly noted complications.

Prognosis Patients with infantile esotropia frequently have good vision despite reduced binocularity. If one eye is turned more frequently than the other, there is increased risk for the development of amblyopia.

Infantile esotropia

On average, by 2 months of age, the optic nerve completes jnfantil. Patients with nystagmus blockage syndrome will have moderate to large amounts of manifest nystagmus and be orthotropic when inattentive, but will have variable esotropia and mild nystagmus when attentive. Identification of the proper deviation in infancy without evidence of cranial nerve palsies or systemic disease to explain the deviation.


Also known as microtropia, monofixation syndrome is normally seen in patients following strabismus surgery for infantile esotropia.

All children with new-onset esotropia require a thorough history, review of systems, and comprehensive examination. However, most cases of infantile esotropia will require surgical intervention. Normal anterior segment exam OU without evidence of cataracts or other media opacities. Latent nystagmus may be present.

The other associated conditions of DVD and latent nystagmus usually appear later in life and may be addressed surgically at that point. Views Read Edit View history. At what age should surgery for infantile esotropia be done?

Rogers MDWanda L. He suggested that this form of esotropia is “a congenital defect of the fusion faculty” Worth, Prematurity, family endoropia or secondary ocular history, perinatal or gestational complications, systemic disorders, use of supplemental oxygen as a neonate, use of systemic medications, and male sex were found to be significant risk factors infanril infantile esotropia.

It is important for the ophthalmologist to take time to discuss the condition with the parents or caretakers. Esotropia, however, can be observed in the setting of neurologic or infantli disorders which highlights the importance of a careful and complete history and exam.

Signs Inward deviation of the eyes, usually large angle Full motility Cross-fixation may lead to appearance of an abduction defect on versions Associated findings include: As alternative to surgery, also botulinum toxin therapy has been used in children with infantile esotropia.

In these patients, surgery is indicated to correct the remaining deviation. It is a specific infanti of esotropia and has been a subject of much debate amongst ophthalmologists with regard to its naming, diagnostic features, and treatment.