Successful strabismus surgery in a child with Moebius syndrome

Moebius syndrome is characterized by congenital paralysis, usually bilateral, of the lateral rectus muscles and the muscles of facial expression. Esotropia is common in these patients. Few reports exist of the surgical results after treatment of strabismus in such patients. We report the case of a 19-month-old white boy with Moebius syndrome who demonstrated an A-pattern esotropia with orthotropia in down-gaze. Use of a conventional surgical approach for an A-pattern esotropia and a bilateral medial rectus recession with a one-half tendon-width supraplacement produced the desired result of orthotropia in primary gaze in our patient.