Results of a series of 216 patients with congenital strabismus operated on at various age levels were analyzed and bear out the following conclusions. Congenital strabismus is a common disorder. Its incidence in the overall strabismus population is at least 50% and may be higher. The first few years of life appear to be critical in the development of normal binocular single vision. Potentiation of the latent binocular reflexes is brought about by bifoveal stimulation during infancy. Early case detection and adequate surgery are mandatory if functional results are to be obtained. It is recommended that surgery be done between 6 to 12 months of age. The functional goal should be to convert a constant tropia to a phoria. This is the most useful yardstick in evaluating results. Surgery done after the second birthday almost always resulted in functional failure.
Taylor DM. Congenital StrabismusThe Common Sense Approach. Arch Ophthalmol. 1967;77(4):478-484. doi:10.1001/archopht.1967.00980020480010