History:  This 5-year-old girl has had crossed eyes as long as the parents can remember.  Vision is 20/20 in each eye and the refractive error is OD +.50 and OS +.50.  The child does not assume a chin down head posture and no fusion is measured.  The remainder of the eye examination is normal.  The treating doctor would obtain a coronal CT, but technical and economic reasons rule this out.  The parents object to the esotropia and the fact that the eyes "shoot up" in side gaze. 

Diagnosis:  "V" pattern

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