Exotropia

What is Exotropia?

This is an ocular disease where the eyes are turned outward which the opposite of crossed eyes. This is a form of strabismus which means misalignment of the eyes. The more common form of strabismus is esotropia which is the medical term for crossed eyes. Strabismus can run in families but just because you have a family history of strabismus it does not mean that everyone will end up with strabismus. Some family members may notice that someone with exotropia may have alternating exotropia or that the person can fixation from one eye to the other. It appears as alternating exotropia.

Exotropia is divided into four categories:

• Congenital
• Intermittent
• Consecutive
• Sensory

What is Congenital Exotropia?

Congenital exotropia is present at birth or is diagnosed shortly after birth. If the pediatrician or parents notice the outward turning of the eyes, they should be seen by an eye doctor.

What is Intermittent Exotropia?

In intermittent exotropia, the eye may only turn out when the child is daydreaming, is tired, or not feeling well. The child may squint or close one eye when they go into bright sunlight. No one knows the reason for children doing this but it is a very common symptom of the condition. Depending on the child’s age, they may complain of intermittent double vision or diploplia.

Usually with time the condition will become more frequent and can eventually be present all of the time. This can lead to amblyopia (decreased vision), loss of binocular vision or depth perception, and the person may develop a blind spot in a portion of their vision. In a few cases, the intermittent exotropia may improve as the child grows into adulthood.

What is Consecutive Exotropia?

This type occurs after over correction of prior esotropia surgery. On a very rare occasion, exotropia may occur with a person who has esotropia. People with strabismus problems have poor or limited fusion. Fusion is a person’s ability to align their eyes to focus on a single point.

What is Sensory Exotropia?

This type occurs when an eye has poor vision. The person loses the ability of being able to focus both eyes on a single object and the eye drifts outward. If the poor vision can be treated, then the condition may resolve once the person has good vision in both eyes. In the case of permanent vision loss, the eye will usually ten to drift out even if surgery is performed to straighten the eye.

Treatment

Initial treatment depends on the severity of the condition. In the beginning, eye exercises and training may enable the person maintain alignment of their eyes and binocular vision. Glasses and patching may also be needed.

If the condition is present more than fifty percent of the time or the person is having significant symptoms, then surgery is indicated.

Summary

If your child is having problems with proper ocular alignment, they need to see an eye doctor. Glasses with the possibility of having prisms added to the glasses may be helpful. Eye exercises and patching may be able to treat the condition. If there are significant symptoms or the eyes are turned out most of the time, surgery may be indicated. Your eye doctor can guide you through the steps of treatment.