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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If a patient is nearsighted or has high astigmatism, keeping the glasses prescription up-to-date may help control the alignment. Sensory Adaptation As a rule during the phoric phase of intermittent exotropia, the eyes are perfectly intermitten and the patient will have bifoveal fusion with excellent stereoacuity ranging between second arc.

The child probably will not mention seeing double, i. Recession of the lateral recti.

Children with exotropia responsive to spectacle correction of hyperopia. The various symptoms seen in intermittent exotropia are as follows:. The exact reason people with intermittent exotropia close one eye in bright light remains unknown.

That is, as long as the eyes are straight some of the time, the brain and two eyes will develop some normal functioning binocular vision and depth perception. Children may squint one eye in bright sunlight, or may rub one of their eyes. If the angle of the exotropia is small, prisms may be used to relieve double vision, particularly in adults, however it does not treat the squimt misalignment itself.

These patients require long-term follow-up even after successful attainment of orthotropia since eyes tend to drift out over time.

Intermittent Divergent Squint in Prematurity and Its Neurophysiological Aspects

Any refractive error especially a hypermetropia should be fully corrected. Progression should be monitored by documenting the size of the deviation, the duration of manifest deviation and the ease of regaining fusion after dissociation from the cover-uncover test.


Intermittent exotropia is an exodeviation intermittently controlled by fusional mechanisms. This is in agreement with von Noorden’s earlier clinical findings using a near-gradient clinical procedure. Can exotropia be treated with prisms in the glasses?

Intermittent Divergent Squint in Prematurity and Its Neurophysiological Aspects

The distance angle to target in surgery for intermittent exotropia. In some cases, the deviation may remain stable for many years, and in a few cases, it may even improve.

Assessing control in intermittent exotropia. Treatment for Intermittent Exotropia Read what one parent wrote regarding making the choice between surgery or Vision Therapy for intermittent exotropia. Am J Ophthalmol ; The role of orthoptics in the evaluation and intermitetnt of intermittent exotropia.

Near measurement exceeds distance measurement, but distance measurement increases with 60 minutes of monocular occlusion. One study has found that children with exotropia are three times more likely to develop a psychiatric disorder in comparison with the general population.

Mosby Year Book; Unlike a pure phoria, intermittent exotropia spontaneously breaks down into a manifest exotropia.

Contrary to the earlier practice of patching one eye for 24 hrs it is now found that patching the eye for 30 min. Burian proposed a classification of intermittent exotropia based on the difference between the distance deviation and the nitermittent deviation.

This plasticity changes with age, with its peak during the first postnatal year. Some patients or family members notice the exotropia more when the patient is tired or daydreaming.

In a study it was shown that near stereoacuity does not correlate well with the degree of control in intermittent exotropia and that performance in this test is intermtitent minimally affected by surgery nitermittent If significant superior oblique overaction and an A-pattern is present, consider an infra placement of the lateral rectus muscles or superior oblique weakening procedure.


Type of Surgery – Several surgical approaches have been used successfully. Differential diagnostic characteristics of intermittent exotropia and true exophoria.

American Association for Pediatric Ophthalmology and Strabismus

Some people may describe that their vision becomes blurry or they may experience double vision when their eyes are misaligned. This page was last edited on 4 Novemberat Although one study reported better outcomes in children who were under the age of 4 years 37most studies have failed to show that age at time of surgery makes any difference in outcome To learn all about this common vision problem, go to What is Convergence Insufficiency?

What is Strabismus or Lazy Eye Surgery? Active anti-suppression and diplopia awareness techniques can be used in cases with suppression.

In very mild cases, there is a chance that the exotropia will diminish with time.

The prolonged monocular occlusion dissipates tonic fusional convergence thereby disclosing the full latent deviation. In a small child, part-time patching of the preferred eye is useful if the child has a preference for one eye over the other, or amblyopia. Singer W, Gray CM. Thus, many advocate targeting an initial overcorrection ranging from 4 to 10 pd. Classification Systems Intermittent exotropia has itnermittent divided into four groups according to the classification system proposed by Burian The patients understand squinf their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.