She was prescribed her full cycloplegic refraction but refused to wear the glasses. Nevertheless, her parents noted that her eyes did not cross as much as before. Indeed, our examinations at the ages of 14 and 17 months showed a residual fixation preference with the right eye, an intermittent esotropia of 40 PD, and a right hypertropia of 10 PD (attributable to inferior oblique overaction) at near fixation. She returned at the age of 19 months, following a shunt revision. Wearing her full cycloplegic refraction, she had 25 PD of constant esotropia at near fixation, with a fine torsional nystagmus. By the age of 2 years, her esotropia had increased to 35 to 40 PD while wearing her glasses. She was treated with bimedial recessions (5 mm OU) and bilateral, inferior, oblique muscle recessions (14 mm OU). Four days postoperatively, no residual head shaking was noted, and the parents reported that the head shaking was gone the day after surgery. Two years later, she had a well-controlled intermittent exotropia of 15 to 20 PD, no nystagmus, and no recurrent head shaking.