Management of infantile esotropia

Surgical treatment has been the accepted mode of treatment for infantile esotropia for decades. The present review of recent literature evaluates the current standing of: type of surgery performed and best timing of surgery to achieve optimal results.

Recent studies suggest that early surgical intervention is of benefit by improving the probability of developing stereopsis. A significant advantage of the type of surgical intervention has yet to be demonstrated by the current studies. Botulinum toxin continues to be used for treatment of infantile esotropia, although it has not been shown to be a superior treatment.

Although many theories exist, the true cause of infantile esotropia remains unknown. The literature suggests that treatment before age 2 and perhaps even earlier improves the potential for binocular vision. After significant review of literature, it is clear that surgery is the treatment of choice for infantile esotropia but no method has a clear advantage. Efforts to define the best surgical procedure and timing of surgery through prospective, randomized multicenter trials are warranted.