Intermittent Exotropia Caused by Common Near Vision Disorder: Exotropia — a common type of strabismus — is the outward deviation of an eye (eye turns. Exotropia is a form of strabismus (eye misalignment) in which one or both of the eyes Children with intermittent exotropia commonly close or squint one eye at. Exotropia, or divergent squint, refers to an eye that turns or diverges outwards. Exotropia may occur from time to time (intermittent exotropia) or may be constant.

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Intermittent Divergent Squint in Prematurity and Its Neurophysiological Aspects

Two-Eyed Vision Some vision problems can’t be improved with just glasses or surgery. In addition, adults with longstanding intermittent deviations will often tolerate under correction, but will have symptomatic diplopia when overcorrected. This technique has found some use in very young children.

The earliest sign of exotropia is usually intermkttent noticeable outward deviation of the eye.

Exotropia – Wikipedia

Classification Systems Intermittent exotropia has been divided into four groups according to the classification system proposed by Burian Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. Although the benefit is usually temporary, occlusion can be used to postpone surgical intervention in responsive patients Children with intermittent exotropia commonly close or squint one eye at times, especially when they are exposed to bright sunlight.

Far distance measurement – Measuring the deviation by fixating a far object reduces measurement variability and helps uncover the full deviation by reducing near convergence. Children who are capable of maintaining binocular vision are also less likely to develop amblyopia. If the primary recession was greater than 6 mm, then perform bilateral medial rectus resections with a conservative approach, as overcorrections are common after resecting against a large recession.


The term ” tenacious proximal fusion ” has been used to describe the fusional after effects that explain the distance near disparity in patients previously classified as pseudo-divergence excess type.

Sensory Adaptation As a rule during the phoric phase of intermittent exotropia, the eyes are perfectly aligned and the patient will have bifoveal fusion with excellent stereoacuity ranging between second arc. In this case, the eye with low vision is unable to work together with the other eye, and therefore, the poorly-seeing eye may have a tendency to drift outward.

Indications for surgery – As with any strabismus the indications for surgery include preservation or restoration of binocular function and cosmesis. The role of stereopsis and early postoperative alignment in long-term surgical results of intermittent exotropia.

The physiology and management of divergent strabismus.

Its Causes, Pathology and Treatment. As with all surgery, there are some risks. International strabismus symposium, BaselS. You may hear about exercises suggested for treating some cases of intermittent exotropia, ssquint, they have not been shown to effectively treat intermittent exotropia.

For the similar condition, where the eyes deviate inward rather than outwardsee esotropia. Although heredity appears to play a role in exodeviations, the etiology of this disorder is probably multifactorial.

This consists of visual exercises. Exotropia is a form of strabismus eye misalignment in which one or both of the eyes turn outward.

Saunders company, Philadelphia Most current theories on the etiology of exodeviations combine the ideas of Duane and Bielchowsky and are of the concept that exodeviations are caused by combination of mechanical and innervational factors, the innervational factors consisting of variation of convergence innervation or disturbed equilibrium between convergence and divergence 8,9.

Am Orthopt J ; 4: During the tropia phase when the exotropia is manifest most patients will show large regional suppression of the temporal retina. Patients with intermittent exotropia rarely complain of symptoms. Nonsurgical management of overcorrection should be tried for at least a month rather than re-operating because of the high likelihood of spontaneous resolution Am J Ophthalmol ; Caltreider M, Jampolsky A: Near measurement exceeds distance measurement.


Exotropia — AAPOS

Levels 5—3 are assessed during an initial s period of observation. Recovery time is rapid, and most people are able to resume normal activities within a few days. Treatment of Intermittent Exotropia Treatment for intermittent exotropia does not have to occur immediately. The child developed jaundice in her neonatal period for which she received phototherapy and exchange transfusion.

Thus, many advocate targeting an initial overcorrection ranging from 4 to 10 prism diopters In only 24 of the patients exotropia develop after 5 years of age. Bilateral lateral rectus recession was done using hang back technique.

Knapp and many other workers advocated early surgical intervention to prevent development of sensory changes that may prove intractable later Patient “breaks” only after cover testing and resumes fusion rapidly without need for a blink or refixation.

Divergence excessintermittent distance exotropiaorthotropia. Galli L, Maffei L. It is better to wait weeks before re-operating on the residual exotropia.

Cooper J, Medow N. Distance measurement exceeds near measurement, even after 60min. Classification of the exodeviations. However, soon the children become asymptomatic due to the development of sensory adaptation. Management options include the following: Can exotropia be treated with patching?

Why does someone with intermittent exotropia close one eye frequently? Minus lenses glasses with a prescription such as -1 or -2 etc. Adjustable suture techniques are helpful in cooperative patients 24, This system is based upon the concept of fusional convergence and divergence and relies on measurements of the distance and near deviations.

Incidence of strabismus in neonates.