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Burton J. Kushner, MD
Madison, Wis

Arch Ophthalmol. 1996;114(12):1531.

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In reply

Almost all articles about the treatment of esotropia consider a successful outcome to range between small-angle esotropia and small-angle exotropia (typically 8-10 PD). Similarly, they do not differentiate between the manifest deviation and the manifest plus latent deviation. Our study convinced me (and I hope the readers) that these differences are important and that these different outcomes should not be lumped together when defining success. Alignment within ±8 PD is an inadequate and imprecise criterion. Small-angle esotropia is better than small-angle exotropia; orthotropia is even better. It therefore amused me that although most articles I have read about esotropia use this inadequate criterion, our study is questioned because our definition of success described an outcome that was not "perfect enough."

Although I agree with most (not all) of the points raised by Drs Scott and Arthur, the thrust of their letter addresses what constitutes a cure (or perfect . . . [Full Text PDF of this Article]

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