Congenital myopic esotropia: a case study

A congenital myope developed a 20 delta left esotropia at 8 months of age. His eyes aligned immediately with a -4.00 D correction and would become esotropic when the glasses were removed. Before eyeglass wear best corrected acuity was reduced for both eyes with the left eye acuity significantly lower than the right. From age 8 to 12 months with part-time eyeglass wear, acuity improved and became equal for the two eyes. At 12 months of age the eyeglasses were lost and within 1 month the strabismus no longer responded to minus lenses and amblyopia reappeared in the left eye. This indicates that a myopic infant may stop bifixating blurred images beyond his far point and then cease to be able to relax convergence thereafter. It has the broader implication that tonic vergence posture and AC/A ratio may develop according to the visual experience of each infant.