ABSTRACT
Management of infantile and early childhood onset strabismus should be completed during early childhood to gain better binocular function and vision. The author experiencep 38 adult patients who had horizontal strabismus without any adequate treatment lasting over 14 years with onset before 6 years of age. They showed large angle of deviation and deep amblyopia. After surgery, stereopsis was never developed in all of the 14 congenital strabismic patients, whereas 30% of the 24 patients with acquired onset showed gross stereopsis. There was abnormal muscular contracture requiring adjustable stutre. All of the patients showed abnormal character psychologically. This study revealed that the longer the duration of misalignment, the greater the chance of deep amblyopia, large angle of deviation, abnormal sensory and motor adaptation, psychological influence, and abnormal muscular contracture. Therefore early initiation of therapy during early childhood should be emphasized.