Current Trends – Intermittent Exotropia Management

Abstract

Intermittent exotropia is a divergent form of strabismus that manifest sometimes and controlled by fusion other times. While the exact aetiology of most exodeviations is unknown, proposed causes include anatomic and mechanical factors with in orbit as well as abnormalities of innervation such as excessive tonic divergence. The examination of a patient who has exotropia includes all components of the comprehensive pediatric or adult ophthalmic evaluation in addition to the sensory, motor, refractive, and accommodative functions. All forms of exotropia should be considered for treatment but all forms of exotropia may not need treatment, particularly some cases of intermittent exotropia. In most cases ocular alignment should be re-established as soon as possible, especially in young children, if the deviation is manifest a large percentage of the time. However, the optimal modes of therapy for exotropia, the long term benefit of early surgical correction, and the superiority of bilateral versus unilateral surgery should be discussed in detail with the patient or parents. Employing a Medline and Pubmed literature search, the purpose of this Review article is to make the diagnosis, establish baseline status, and determine appropriate initial therapy.

Keywords

• exotropia
• intermittent exotropia
• surgical treatment