| Sumario: | Background: Historically, infantile esotropia was considered to be the result of a congenital muscle dysfunction. More recent evidence shows that the mechanism is in fact a disruption in the development of neural circuitry in the visual cortex occurring around three months of age. Training to inhibit sensory adaptations and to stimulate cortical mechanisms of binocularity becomes essential in the treatment of this condition. Such improvement is achievable by means of vision therapy. Despite this, surgical correction remains the primary treatment option employed. Case Report: An eight-month-old presented with infantile esotropia. Upon discussion of surgical vs non-surgical treatment options with the parents, a resistance to surgery due to the potential risks associated with the procedure was revealed. Vision therapy became the sole and necessary treatment option. Efficacy and techniques of vision therapy for the treatment of strabismus in infants are discussed. Conclusion: In certain instances, such as in this case report, there are contraindications or resistance to surgery. Understanding the use of vision therapy as an alternative to surgery is imperative in achieving ocular alignment and binocularity. There is a need for increased awareness in the profession of optometry regarding the mechanism by which infantile strabismus develops and the effectiveness of vision therapy in the infantile population. This awareness can allow better education for patients and parents and can provide a successful alternative to surgical correction.
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