Purpose/methods: We observed a change in the typical circadian, 24-hour pattern of strabismus (esotropia) in a 2-year-old patient. Methods used include study of the history of the deviation pattern, observation, and measurement of the deviation on the day after travel and six weeks later.
Results/conclusions: The patient responded to standard recession-resection surgery with a straight eye position daily, through three months of follow-up. Rapid travel over six time zones probably caused the change in the circadian pattern of strabismus.