H. R. Padmini1, Shruthi Das Shetty2
INTRODUCTION
Infantile esotropia is an idiopathic esotropia previously called as congenital esotropia where there is an inward movement of one or both eyes. Up to 4 months of age, infrequent episodes of convergence are normal but thereafter ocular misalignment is abnormal. Congenital esotropia commonly referred as crossed eyes is not present since birth but usually develops within first six months of life in an otherwise normal infant with no significant refractive error and no limitation of ocular motility. Angle of deviation is usually constant and fairly large >30*. Infantile esotropia is usually associated with inferior oblique over action usually developing after one year of age, dissociated vertical deviation (DVD) in about 70-90% cases and latent horizontal nystagmus. Patients with infantile esotropia usually do not develop binocular vision. There is alternate fixation in primary gaze and in lateral gaze there is cross fixation. Amblyopia develops in 25-40% when patient fixes more with one eye. Thus surgical correction should be done early in life to avoid amblyopia. Here we encounter a rare case of infantile esotropia with medial rectus insertion anomaly who presented in her adolescence and underwent a definite cosmetic surgical correction by medial rectus recession and ipsilateral lateral rectus resection at same time.
