Episodes of strabismus surgery in the under-14 year age group in West Berkshire have reduced by 42%, from 22.7 to 13.2 per 10,000 population, between 1968 and 1985. Clinical audit of patterns of referral shows that the incidence of constant esotropia has reduced by 55%, from 28.3 to 12.8 per 10,000 population, between 1971 and 1991.