Esotropia presenting during the first 6 months of life is termed infantile esotropia and is divided into the following categories: congenital esotropia and infantile accommodative esotropia. Congenital esotropia is characterized with large constant esotropia, onset birth to 6 months of age, amblyopia common (50–60%) and associated motor phenomenon. Preoperative evaluation is done to check the degree of amblyopia, angle of strabismus, limit of abduction. The optimal age for surgery for infantile esotropia is controversial. The first choice procedure is Cüppers-Faden procedure, and then we can also perform myopia procedure. Infantile accommodative esotropia is characterized by acquired esotropia, by onset at 2 months to 1 year of age, by a hypermetropia of more than +2.5 D, by a moderate up to a large esotropia and by a variable often intermittent angle. The treatment is a full hypermetropic correction determined by a cycloplegic refraction; usually more than +3.0 D. Normal sensory strabismus and non-accommodative acquired esotropia are also common. Exotropia can be intermittent, sensory, and congenital. A congenital exotropia is very rare condition the treatment is a surgery after 6 months of age, preferable bilateral lateral rectus recessions. After surgery don’t forget a correct amblyopia treatment. During the planning of tribological surgery it’s important that the upper and lower dosage limitation has to be kept in mind.