Study: Early surgery improves the visual and motor development of infants with esotropia

The study's conclusions were based on the results of the Infant Developmental Skills Survey (IDSS) completed before surgery by the parents of 143 esotropic infants between ages three and 10 months and after surgery by the parents of 58 infants between ages six and 11 months. The survey contains 25 items designed to evaluate an infant's sensorimotor and gross motor skills.

Parents of 194 infants aged three to 11 months with normal ocular alignment completed the survey as a control group. The postsurgical group included only infants who were orthotropic or intermittently heterotropic with or without spectacles at the six- to eight-week postoperative visit. A subset of the parents of 40 infants completed the survey both before and after surgery.

The presurgical survey results of the 4-, 5-, 6-, 7-, 9-, and 10-month-old patients indicated significantly delayed achievement of sensorimotor milestones compared to the control group. Five-, 9-, and 10-month-old patients showed significantly delayed gross motor milestone achievement before surgery compared to controls. After surgery, neither the achievement of sensorimotor nor gross motor milestones was delayed compared to controls. Postsurgical sensorimotor development was significantly faster than in age-matched controls.

The authors attributed the rapid rate of development seen after surgery to improved binocular function in the infants. Many of the IDSS items are visually demanding, and better binocular function may facilitate their performance. However, the authors noted that the evaluation of stereopsis and fusion was not part of the current study.