Prospective assessment of acuity and stereopsis in amblyopic infantile esotropes following early surgery.

Sensory and motor status were evaluated prospectively in a group of 84 infantile esotropes with fixation preference. Treatment consisted of part-time occlusion therapy, spectacles for bilateral hyperopia of 3.0 diopters or more and bimedial rectus recession. Successful occlusion therapy was associated with both a decrease in fixation preference and a "trade-off" in grating acuities of preferred and nonpreferred eyes. Three patients responded to occlusion therapy and spectacles alone; the remaining patients were treated surgically before their first birthday. Adequate alignment was achieved in over 75% of patients. During a mean follow-up of 28 months, 31 patients required further surgery to maintain horizontal and/or vertical alignment. Following occlusion therapy and surgery, acuity development proceeded normally. Postoperatively, approximately 35% of patients had at least gross stereopsis with random dot stereograms.