Diagnosis
Differential Diagnosis
Clinically Infantile esotropia must be distinguished from:

VIth Cranial nerve or abducens palsy
Nystagmus Blockage Syndrome
Esotropia arising secondary to central nervous system abnormalities (in cerebral palsy for example)
Primary Constant esotropia
Duanes Syndrome

Treatment
According to a Cochrane review of 2012, controversies remain regarding type of surgery, non-surgical intervention and age of intervention.The aims of treatment are as follows:

The elimination of any amblyopia
A cosmetically acceptable ocular alignment
Long-term stability of eye position
Binocular cooperation

Initially
It is essential that a child with strabismus is presented to the ophthalmologist as early as possible for diagnosis and treatment in order to allow best possible monocular and binocular vision to develop. Initially, the patient will have a full eye examination to identify any associated pathology, and any glasses required to optimise acuity will be prescribed – although infantile esotropia is not typically associated with refractive error. Studies have found that approximately 15% of infantile esotropia patients have accommodative esotropia. For these patients, antiaccommodative therapy (with spectacles) is indicated before any surgery as antiaccommodative therapy fully corrects their esotropia in many cases and significantly decreases their deviation angle in others.Amblyopia will be treated via occlusion treatment (using patching or atropine drops) of the non-squinting eye with the aim of achieving full alternation of fixation. Management thereafter will be surgical. As alternative to surgery, also botulinum toxin therapy has been used in children with infantile esotropia. Furthermore, as accompaniment to ophthalmologic treatment, craniosacral therapy may be performed in order to relieve tension (see also: Management of strabismus).
but do not comment on the number of operations undertaken. A recent study on 38 children concluded that surgery for infantile esotropia is most likely to result in measureable stereopsis if patient age at alignment is not more than 16 months. Another study found that for children with infantile esotropia early surgery decreases the risk of dissociated vertical deviation developing after surgery.Aside the strabismus itself, there are other aspects or conditions that appear to improve after surgery or botulinum toxin eye alignment. Study outcomes have indicated that after surgery the child catches up in development of fine-motor skills (such as grasping a toy and handling a bottle) and of large-muscle skills (such as sitting, standing, and walking) in case a developmental delay was present before. Evidence also indicates that as of the age of six, strabismic children become less accepted by their peers, leaving them potentially exposed to social exclusion starting at this age unless their eye positioning is corrected by this time (see also: Psychosocial effects of strabismus). References
External links

Infantile esotropia, Medscape, updated 30 May 2012