Congenital (infantile) esotropia is an ET that appears in an infant in the first 6 months of life with normal neurologic status, with normal ocular examination (except for strabismus) and with a refractive error expected for age (usually low to moderate hyperopia), the correction of which does not eliminate esotropia.

The  infant has either alternation with cross fixation or fixation preference for one eye ( implying amblyopia ), these infants with fixation preference  should alternate fixation before surgery, but surgery is often carried out by many surgeons before this is accomplished. Amblyopia therapy in such cases can be continued after surgery.

The age chosen for surgery depends on the surgeon’s preference and varies from as early as 4 months to 3 years of age or more if alternation is confirmed. For me I do surgery for infantile esotropia as early as 4 months' age , as long as the diagnosis is confirmed by the above criteria . For me early interference results are the same as late interference which is preferred by many colleagues , this was confirmed by the long term follow up of hundreds of cases within our hands' statistics . 

Surgery for infantile esotropia consists of bimedial rectus recession, , a three-muscle procedure combining a bimedial rectus recession with a resection of one lateral rectus or in a very few cases a four-muscle procedure consisting of a bilateral recession-resection.