The management of childhood esotropiaChildhood esotropia encompasses various presentations and requires a tailored approach for each case. Childhood esotropiaChildhood esotropia, common especially below the age of five, presents in diverse forms such as intermittent, sudden onset, or constant esotropiaEsotropia. Accurate examination, including visual acuityVisual acuity measurement, alignment assessment, and cycloplegic refractionRefraction, is crucial for diagnosisDiagnosis and treatment planning. While some children may resist examination due to age or other factors, close follow-up is recommended to avoid missing significant refractive errors, a treatable cause of poor vision and esotropiaEsotropia. Treatment typically involves correcting refractive errors, addressing amblyopia if present, and considering alignment surgerySurgery to promote binocular visionBinocular vision or improve appearance. Surgical intervention aims to align the eyes, with early correction potentially enhancing binocular function and techniques vary based on factors like age, degree of deviation, and associated conditions like developmental delay. Patient/parent counselling is essential to discuss the benefits, risks, and potential need for repeat surgeriesSurgery. Effective treatment involves a combination of refractive correction, amblyopia management, and surgical intervention tailored to each case's unique presentation and goals.