The document discusses the nature and management of comitant convergent and divergent strabismus. It covers factors to consider in evaluation such as age, angle of strabismus, and sensory adaptations. For management of convergent strabismus, it discusses approaches for fully accommodative esotropia, partially accommodative esotropia, convergence excess, and non-refractive esotropias. For divergent strabismus, it discusses divergence excess, near exophoria, and constant exotropia. Surgical correction is usually needed for large angle or non-accommodative deviations.