Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Dec;43(6):643-51.
doi: 10.3129/i08-115.

Timing of surgery for infantile esotropia: sensory and motor outcomes

Agnes M F Wong  1
Affiliations
Review

Timing of surgery for infantile esotropia: sensory and motor outcomes

Agnes M F Wong. Can J Ophthalmol. 2008 Dec.

Abstract

Infantile esotropia is a common ophthalmic disorder in childhood. It is often accompanied by profound maldevelopment of stereopsis, motion processing, and eye movements, despite successful surgical realignment of the eyes. The proper timing of surgery has been debated for decades. There is growing evidence from clinical and animal studies that surgery during the early critical periods enhances sensory and ocular motor development. The Congenital Esotropia Observational Study has defined a clinical profile of infants who will benefit most from early surgery, and several other studies have shown that early surgery does not lead to adverse long-term effects. Clinicians now should consider offering early surgery to patients with large-angle, constant infantile esotropia at or before 10 months of age.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Summary of stereopsis outcome by age at surgery. Each circle indicates the prevalence of stereopsis from each study cited. Short horizontal dashes represent mean prevalence of stereopsis for different age groups. (1, Birch et al.; 2, Ing; 3, Ing; 4, Ing and Okino; 5, Wright et al.; 6, Birch et al.; 7, Birch and Stager; 8, Birch et al.; 9, Birch et al.; 10, Kushner and Fisher; 11, Hiles et al.; 12, Zak and Morin; 13,Taylor.)
Fig. 2
Fig. 2
Motion visual evoked potential (mVEP) outcome by age at surgery. The symmetry of mVEP is measured by an asymmetry index. The higher the asymmetry index, the more abnormal and asymmetric the mVEP responses. The mean asymmetry index in the early surgery group was similar to that in age-matched control subjects, and was significantly lower than that in the standard surgery group.
Fig. 3
Fig. 3
Optokinetic nystagmus (OKN) outcome by age at surgery. The symmetry of OKN is measured by a nasal bias index. The higher the nasal bias index, the more abnormal and asymmetric the OKN responses. The mean asymmetry index in the early surgery group was similar to that in age-matched control subjects, and was significantly lower than that in the standard surgery group.
Fig. 4
Fig. 4
Clinical profile of infants who will benefit most from early surgery.
See this image and copyright information in PMC

Comment in

References

    1. Greenberg AE, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia: a population-based study. Ophthalmology. 2007;114:170–4. - PubMed
    1. Mohney BG, Erie JC, Hodge DO, Jacobsen SJ. Congenital esotropia in Olmsted County, Minnesota. Ophthalmology. 1998;105:846–50. - PubMed
    1. Jampolsky A. When should one operate for congenital strabismus? In: Brockhurst RJ, Boruchoff SA, Hutchinson BT, Lessell S, editors. Controversy in Ophthalmology. Philadelphia, Pa: WB Saunders; 1977. pp. 416–22.
    1. Parks MM. Operate early for congenital strabismus. In: Brockhurst RJ, Boruchoff SA, Hutchinson BT, Lessell S, editors. Controversy in Ophthalmology. Philadelphia, Pa: WB Saunders; 1977. pp. 423–30.
    1. von Noorden GK. Binocular Vision and Ocular Motility: Theory and Management of Strabismus. 5. St. Louis, Mo: CV Mosby; 1996.

Publication types

Grants and funding