To do good research in the field of strabismus, one must think fourth dimensionally—the fourth dimension being time. One needs to know not only the short-term outcome of a given study, but also how those results hold up over time. Frequently manuscripts dealing with strabismus report data on patients who have been followed up for a short while after surgery; the reader never learns how those same patients fare as more time passes. Consequently, McNeer et al1 are to be heartily congratulated for their article in this issue of the Archives. They report additional follow-up on a group of patients who were treated with bilateral botulinum toxin type A injections for infantile esotropia. (The initial report has been published.2) At first glance, the results they report seem good, so good in fact that the reader must answer the question: "Should botulinum toxin type A be the treatment of