Congenital absence of lateral rectus muscle.

A four-year-old female presented with a 60 PD left esotropia and Axenfeld's anomaly OU. Cosmetic strabismus surgery was undertaken, at which time it was discovered that the left lateral rectus was absent. The medial rectus was recessed, without change in the esotropia. At a second procedure six months later, the superior and inferior rectus muscles were transposed to the area of the missing lateral rectus. Follow-up examination revealed an 8 PD left esotropia with full ductions.