Prognosis
Infantile esotropia
The goal of treatment is to align the eyes. Usually, small-angle esotropia (up to 8 prism dioptres) will result in stable alignment and allow rudimentary stereopsis. Elevation in adduction, latent nystagmus, and amblyopia occur in 30% to 50% of patients and may require further treatment. Although some studies suggest that aligning the eyes within the first 6 months of life results in better binocular function, this is not universally accepted.
Accommodative esotropia
The goal of treatment is to align the eyes without delay. This may be achieved with spectacles or surgery or both. As successful alignment of the eyes is a prerequisite for binocular functions such as depth perception and stereopsis, delay in alignment decreases the probability of achieving a high level of these functions.[45]
Intermittent exotropia
Strong epidemiological studies are lacking on this topic. Although the consensus is that most patients with intermittent exotropia will develop less control over time and require some form of treatment (including surgery), if it remains acceptable, the development of amblyopia and decreased binocular function are rare.[46][47] In patients requiring surgery, recurrence of intermittent exotropia may occur following treatment. In one study, approximately one third of patients required more than one surgery to achieve a satisfactory outcome.[48] Although no long-term prospective studies are available, the outcome for most patients appears to be positive, with stable post-operative ocular alignment, no amblyopia, and good binocular function. Under- and persistent over-corrections may occur; however, requiring additional conservative and surgical treatment.[49]
Other forms of strabismus
The prognosis of other forms depends on the underlying cause, severity and complexity of the strabismus. If more than one muscle is involved (e.g., in oculomotor nerve [cranial nerve III] palsy), the surgical treatment becomes more difficult.
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