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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No amblyopia was detected preoperatively. Baillier, Tindall and Cox, ; p. Optokinetic response to detect smooth pursuit and saccade eye movements will aid in the diagnosis of amblyopia.

The elimination of any amblyopia A cosmetically acceptable ocular alignment long term stability of eye position binocular cooperation. He reasoned that the primary problem is mechanical and potentially curable if the deviation could be eliminated in infancy.

Ptosis is also frequently observed. There is some debate about whether three-muscle surgery should be endotropiq at the time of initial operation for large angle esotropia.

Infantile Esotropia – EyeWiki

Forced duction testing can be helpful in confirming the diagnosis in this situation. Cross-fixation congenital esotropiaalso endptropia Cianci’s syndrome is a particular type of large-angle infantile esotropia associated with tight medius rectus muscles. CSM central, steady, maintained OS: There appears to be a multifactorial genetic basis for congenital esotropia; however, no specific genes have been identified. Understanding visual milestones and anatomic development is mandatory for precise visual assessment of the child.

Patients with congenital esotropia often cross-fixate. The patient was born full term by normal spontaneous vaginal delivery without complications.

Many develop some degree of dissociated infanfil divergence DVD.


Binasal occlusion can be used to discourage cross-fixation. For these patients, antiaccommodative therapy with spectacles is indicated before any surgery as antiaccommodative therapy fully corrects their esotropia ijfantil many cases and significantly decreases their deviation angle in others.

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Infantile Esotropia — AAPOS

Krimsky and Hirschberg methods Ductions full OU Small angle esotropia with distance fixation Looks straight orthotropia with near fixation Figure 2: The incidence ihfantil overcorrection is low following surgery for infantile esotropia.

Besides having strabismus, the majority of children with congenital esotropia are developmentally normal. Claude Worth believed that infantile esotropia was a congenital defect in fusion faculty, suggesting that despite correction, patients with infantile esotropia could never achieve good binocular vision.

Post-operative gaze photos showing preservation of good motility. Languages Italiano Edit links. Surgery for large angle congenital esotropia. Latent nystagmus may be present. Amblyopia treatment Amblyopia treatment is often reserved for those patients with infantio strong fixation preference. 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.

Worth’s “sensory” theory was countered by Chavasse’s “motor” theory. Results and incidence on secondary surgery in a long-term survey of 74 cases treated before 36 months of age”. This led to the idea that early surgery for infantile esotropia could potentially result in good binocular vision.

Infantile esotropia

endotropis If signs of inferior oblique overaction are noted, surgical weakening of the inferior oblique muscles is usually performed simultaneously. Bernard Chavasse proposed that the neural components of binocular vision are present in congenital esotropia.


Will my baby have good depth perception when infabtil Equal visual acuity is normally observed, with amblyopia occurring in less than half of patients. Historically the term ‘congenital strabismus’ was used to describe constant esotropias with onset between birth and six months of age.

Should any significant refractive endotropa be detected, the full cycloplegic refraction should be prescribed. Patients with restrictive esotropia will frequently have incomitance and an anomalous head posture. Congenital fibrosis of the extraocular muscles Patients with congenital fibrosis of the extraocular muscles will frequently have poor ductions.

Ocular rotation Some infants may show some ensotropia of abduction upon initial examination of eye movements as a result of cross fixation.

Treatment of amblyopia, along with multiple surgeries, may be required to achieve the best visual and binocular outcomes. The timing of strabismus surgery for infantile esotropia has been greatly debated and studied. Multiple surgeries may be needed to correct large angle esotropia.

Infantile esotropia is also called congenital esotropia [See figure 1]. Characteristics of infantile esotropia following early bimedial rectus recession. Sight-threatening complications from strabismus surgery are uncommon. It occurs because the brain ignores input from an eye. The ability of an eye to maintain fixation is assessed by occluding the contralateral eye to stimulate fixation on a target and then assessing whether fixation is maintained under binocular conditions when the contralateral eye is unoccluded.

No other forms of nystagmus follow this pattern.

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