Acute onset concomitant esotropia: when is it a sign of serious neurological disease?

The onset of concomitant strabismus in most cases occurs during early infancy or childhood.' The two major categories of early onset concomitant esotropia are accom- modative and congenital (infantile). While some disagreement exists as to the appropriate treatment of these strabismic disorders, there is general consensus that these are not usually causally related to any serious underlying neurological pathology.