In fact, a significant portion of strabismus occurs in childhood, and often the earlier strabismus occurs, the worse the treatment effect, so why is strabismus likely to occur in childhood? The main reasons are as follows: 1. Imperfect development: Children, especially infants, have imperfectly developed binocular monovision function and cannot coordinate extraocular muscles well, so any unstable factors can contribute to the occurrence of strabismus. The monocular function of human is gradually developed later in life, and the establishment of this function is gradually developed and matured by repeatedly receiving the stimulation of external clear images, just like the visual function. The establishment of precise fusion function lasts until after 5 years of age, and the establishment of stereopsis is the latest, and can approach that of adults only at 6-7 years of age. Therefore, it is said that the period before 5 years of age when the monocular function of both eyes is not perfect is the high incidence of strabismus in children. 2. Congenital anomalies: This kind of strabismus is mostly caused by anatomical defects such as abnormal development of the position of the congenital extraocular muscles, abnormal development of the extraocular muscles themselves, incomplete mesodermal differentiation, poor separation of the ocular muscles, abnormal and fibrotic muscle sheaths, or paralysis of the nerves innervating the muscles. In some cases, the head and face of the baby are damaged by the use of forceps during delivery, or the mother exerts excessive force during delivery, resulting in punctate hemorrhage in the brain, and the hemorrhage happens to be in the nucleus of the nerve that governs eye movements, causing extraocular muscle paralysis. In addition, there are genetic factors. Strabismus is not inherited in all members of the family, and the defect is often inherited indirectly to the next generation of children. Strabismus generally occurs within 6 months of birth and is called congenital strabismus, which does not have the basic conditions for establishing binocular vision and is most harmful to the development of visual function. 3, eye development characteristics make children susceptible to strabismus: because children’s eyes are small, the eye axis is short, and they are mostly farsighted, and because children’s corneal and crystal refraction force is large, the ciliary muscle contraction force is strong, that is, the adjustment force is strong. Such children need more adjustment force to see objects clearly, and at the same time, both eyes also turn inward with force to produce excessive convergence, which easily causes internal strabismus, and this kind of internal strabismus is called regulatory internal strabismus. 4.Insufficient control of the eye movement center: if the collection is too strong or the abduction is not enough or both exist at the same time, it produces an internal strabismus; on the contrary, if the abduction is too strong and the collection is not enough or both exist at the same time, it produces an exotropia. 5. The internal strabismus that occurs within 6 months of age is mostly “congenital internal strabismus”. Many experts in pediatric ophthalmology at home and abroad believe that for congenital internal strabismus, the best age for surgery starts at 6 months, and that correction of the internal strabismus to a certain extent before the age of 2 years can lead to a certain degree of binocularity and stereopsis. 2 years old before the completion of eye position correction, fusion function may be formed; after the age of 4 years, fusion function is rarely formed. Therefore, large-angle internal strabismus should be operated as early as possible if it can alternate gaze and there is no adjustment factor. We use a strabismus objective diagnosis system that enables early measurement of strabismus in children with strabismus as young as a few months old, and based on our experience with general anesthesia surgery design, we have carried out early surgical treatment of congenital internal strabismus. After follow-up, the long-term results were found to be satisfactory.