Characteristics of early onset esotropia

Some 115 patients with a reported onset of esotropia within the first six months of life were studied retrospectively to assess ocular findings and the evolution of any changes with time. All patients had been treated by one ophthalmologist and one orthoptist since 1972. Of the 115 patients, 27% had an accommodative element associated with the esotropia. Patients with an accommodative esotropia had higher levels of hypermetropia when compared to the non-accommodative group, but there were no other distinguishing characteristics. The groups exhibited a large variation in angle size, ranging from four to 45 degrees at the initial visit. The presence of fusion, amblyopia and the degree of hypermetropia had no significant effect on the course of the squint. Amblyopia was noted in 67% of cases and appeared to stabilise at a later-than-expected age, with 66% of patients with amblyopia stabilising between eight and 11 years. Surgical intervention had no effect on the incidence of amblyopia at the initial or final visits.