There are multiple surgical techniques used to treat infantile esotropia with the main goal being to align the eyes so that binocular vision may develop.The most common initial treatment is either bilateral medial rectus muscle recessions or unilateral medial rectus muscle recession and lateral rectus muscle resection. For infants with very large angles of esotropia (>60 prism diopters [PD]), surgery on 2 muscles alone may not be adequate to correct the strabismus. Approaches to these patients have included large bilateral medial rectus muscle recessions, smaller bilateral medial rectus muscle recessions combined with resections of 1 or both lateral rectus muscles or botulinum toxin augmented bimedial recession.