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9 month old infant with infantile esotropia. What treatment should be done?

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Practicing since : 1977
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I have a 9 month old infant with infantile esotropia (bilateral). She does not have constant esotropia, her eyes take turns focussing. We patch the stronger eye for 3 hours daily. The last deviation measurement was 35 prism diopters. Our doctor wants to wait until she is about 18 months before doing strabismus surgery but I've read about early surgery being more beneficial to these patients and this is backed up by clinical trials. In her case is it better to wait in case she improves? Or do early strabismus surgery?
Posted Tue, 13 Nov 2012 in Vision and Eye Disorders
Answered by Dr. N. K. Misra 14 hours later
thanks for sending your query to us.
What your child has is accommodative squint .We have seen very promising results with cycloplegics.Atropine being stronger gives better result or cyclopentolate being milder has to be put in daily.
Surgery for these toddlers is difficult in follow up and further management.
consult your treating doctor and get back to me in case you need further information and help.
Above answer was peer-reviewed by
Follow-up: 9 month old infant with infantile esotropia. What treatment should be done? 19 hours later
Dr. Misra,

So you are saying she has 'accommodative esotropia' not 'infantile esotropia'? Or can they be the same thing?
Answered by Dr. N. K. Misra 3 hours later
thanks for getting back to us.
in cases of infantile esotropia there is a lot of accommadative element in play.
there are few things which i have to point out,alternate occlusion prevents development of binocular vision and we use this to get the XXXXXXX angle for surgery.
A drug trial gives immedite results and i have prevented a lot of surgeries with this technique.
children have very strong accommodation and overplay of this in inetial stages leads to infantile esotropia.
Give this idea a thought and then talk to your doctor.
Above answer was peer-reviewed by
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