Esotropia is the most common type of strabismus.It is classified as primary and secondry esotropia. Esotropia can arise for a variety of reasons, including hypermetropia. Accommodative esotropia (AE) is the most common type of childhood esotropia. It is classically divided into 3 categoriesfully refractive (AE), non-refractive and Partially (AE). Timely and full correction of the hyperopic refractive error protects normal binocular vision.Manage any associated amblyopia.Surgical correction is recommended if esotropia exceeds 15 prism diopters. The preferred surgery is recession of medial rectus muscle. Regular surgery of (PAE) is based on the maximal non-accommodative component of the esodeviation as measured through the full cycloplegic correction. The surgical amount for recession of bilateral medial rectus muscle for PAE with excessive convergence is usually difficult to determine, and under correction or residual esotropia is common in these patients. Therefore, strategies like augmention surgery has been proposed and performed to identify surgical targets for patients with esotropia associated with high hypermetropia. An increase in the surgical amount may also be required in very high hyperopic individuals.