ABSTRACT
Infantile esotropia is a large angle esodeviation that presents within the first year of life. It represents the most common form of strabismus, with an incidence of 1 to 2%. Although the accepted treatment for this entity is by surgical alignment of the eyes, the refractive changes in infantile esotropes and their implications on the outcome has not been adequately studied. A series of 90 cases diagnosed as infantile esotropia collected from the pediatric Ophthalmology department between 1997 and 2001 were studied retrospectively to investigate the refractive state following the initial management and its effect on the ocular alignment and the outcome of therapy. The follow-up period ranged from three to seven years. Out of the 90 patients, 34 patients [37.7%] showed significant refractive error changes after initial surgical alignment that needed further correction. Among these, 25 were fully corrected with glasses and the remaining nine patients needed second surgical interference. On the other hand, 56 patients [62.2%] showed stability of refraction with no further interference. The previous findings lead to conclude that surgical alignment alone does not give the final security for infantile esotropes and that later refraction changes should not be underestimated as it may influence the outcome