Primary infantile-onset esotropia--20 years later

Of 286 cases of primary infantile onset esotropia operated upon early, 42 were reviewed after 20 years. Four of them achieved normal bifoveal stereoscopic vision (40" arc) despite the fact that at review after 3-4 years of age none had better stereopsis than 80" arc. Emphasis is laid on three main factors which may influence the result of early surgery and on the eventual attainment of normal binocularity, i.e. pre-operative alternating occlusion, accurate and repetitive muscular surgery, post-operative occlusion until parallelism is achieved in all directions of gaze and meticulous follow-up into the mid-teens.