How Early Is Early Surgery in the Management of Strabismus?

Effect of preoperative stability of alignment on outcome of strabismus surgery for infantile esotropia

“…[1][2][3][4][5][6][7] The earliest age at which surgery is recommended has been the subject of debate. Wright et al 9 initially reported high-grade stereopsis in three of seven patients operated on before 4 months of age.…”

Outcome of early surgery in infantile esotropia: Our experience in tertiary care hospital

“…It was Taylor who in the first published study on stereopsis following surgery reaffirmed that binocularity is possible if surgery is done before 2 years of age and the residual deviation is less than 10 PD. 4 Von Noorden initially had challenged the concept of operating as early as 6-12 months of age due to a contention that it will lead to a high number of overcorrections and undercorrections. 2 Banks et al in 1974 studied 24 persons with subnormal binocularity caused by esotropia and tested them for interocular transfer of tilt after effect and concluded that the sensitive period for the development of binocularity begins several months after birth and peaks between one and three years of age and that early corrective surgery in infantile esotropia could lead to development of cortical binocularity.…”

“…4,[8][9][10][13][14][15] The extent of bimedial recession is generally calculated based on Hirschberg test as prism bar cover test is not possible in infants. The present analysis describes the surgical results in infantile esotropia cases treated at our tertiary care hospital between February 2013 and August 2014.…”

“…The characteristics of congenital esotropia agreed upon are, age of onset by 6 months, large angle esotropia, cross fixation, normal neurological status, hyperopia as per age not influencing esotropia, nystagmus in few cases. 4 The optimum age for surgery in infantile esotropia has fluctuated over the last four decades with an increasing trend towards early surgery. Although there is still no unanimous consensus as to the exact age when infantile esotropia is to be addressed, yet there is recognition that even subnormal binocularity can be achieved only if surgical alignment is achieved.…”

“…Although there is still no unanimous consensus as to the exact age when infantile esotropia is to be addressed, yet there is recognition that even subnormal binocularity can be achieved only if surgical alignment is achieved. [4][5][6][7][8] Very few studies have been done in India on the results of early surgery in infantile esotropia due to various factors like deep rooted beliefs on either late surgery or no surgery particularly in rural areas. However, lately there has been an increase in the referral of strabismus cases due to an increased awareness.…”