| 27. | demonstrates a child with a true congenital esotropia, which by definition onsets before the age of six months. The deviation is characteristically large and a diagnosis can readily be made across your waiting room. |
| 28-29. | Many children will alternate fixation as demonstrated in images 28-29 and these children do not generally become amblyopic because they use each eye part of the time. Should they not do so, occlusion therapy is undertaken to induce the child to fixate alternately with each eye. |
| 30-31. | Parents will tell you that the deviation is always worse when the children are tired (see images 30-31) and... |
| 32. | may run in families. |
| 33-34. | There is no accommodative component to the strabismus and glasses to correct any hyperopia are generally without benefit. |
| 35. | The treatment for congenital esotropia is surgical and... |
| 36. | shows a child who has undergone recession (weakening) of both medial rectus muscles. This has left her with a small residual esodeviation... |
| 37. | which was treated with bilateral resections (strengthening) of the lateral rectus muscles. |
| 38. | Shows apparently satisfactory alignment, but these children never achieve true binocularity or stereoscopic vision. Many develop an accommodative component to their strabismus between the ages of two and four and require treatment with hyperopic corrective spectacles. They must also be monitored carefully throughout their early years as they run a significant risk of developing amblyopia. |