Many binocular patients who have a small or absent tropia (up to 8 prism diopters eso or exo, and 4 prism vertically) and possible superimposed phoria exhibit monofixation syndrome (MS) or microtropia. Microtropia may be a primary constant, primary decomtpenstaing or secondary microtropia.Microtropia has been classified as Primary and Secondary or microtropia with identity, or without identity and having unilateral or bilateral microtropia. Microtropia is characterized by Consistent findings and Variable findings. There is no specific treatment for the deviation present. The management of microtropia is limited only to the treatment of sensory problems as suppression scotoma, ARC, amblyopia and eccentric fixation.The prognosis for alignment and maintenance of subnormal binocularity is excellent.