Acquired Exotropia Follow-up

  • Author: Neepa Thacker, MBBS, MS, FRCS, DNB; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Dec 10, 2009
 

Further Outpatient Care

  • Strabismus surgery is performed as an outpatient procedure.
  • Although regimens vary among surgeons, regular follow-up visits are necessary to assess eye alignment and to examine fusional abilities.
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Complications

  • If left untreated, intermittent deviations could progress to constant exodeviations, with subsequent development of amblyopia and loss of fusional abilities in young children.
  • No specific complications are related to surgery for this condition; however, complications of eye muscle surgery in general apply.
  • Postoperative complications include overcorrection, undercorrection, residual A- or V-pattern strabismus, and diplopia in side gazes due to lateral incomitances.
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Prognosis

  • Some factors that affect the prognosis are as follows:
    • Some authors believe that surgical alignment before age 4 years yields better results with lower risks for amblyopia. On the other hand, even a slight overcorrection increases the risk of loss of bifoveal fixation at this young age.
    • Patients with better fusional control preoperatively do better postoperatively.
    • Correction of refractive error should be continued postoperatively.
    • Tenacious proximal fusion may predict better postoperative results.
  • Both motor alignment and sensory functional improvement should be included in the postoperative assessment of response to surgery.
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Contributor Information and Disclosures
Author

Neepa Thacker, MBBS, MS, FRCS, DNB  Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital, India

Disclosure: Nothing to disclose.

Coauthor(s)

Federico G Velez, MD  Assistant Clinical Professor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, University of California at Los Angeles School of Medicine

Federico G Velez, MD is a member of the following medical societies: American Academy of Ophthalmology and American Association for Pediatric Ophthalmology and Strabismus

Disclosure: Nothing to disclose.

Arthur L Rosenbaum, MD  Chief, Division of Pediatric Ophthalmology, Professor, Vice Chairman, Department of Ophthalmology, University of California at Los Angeles School of Medicine

Arthur L Rosenbaum, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Bartiss, OD, MD  Medical Director, Ophthalmology, Family Eye Care of the Carolinas

Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, and North Carolina Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

J James Rowsey, MD  Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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Patient with intermittent exotropia at distance only. Patient is fixing with the left eye. Note the outward deviation of the right eye.
Patient with intermittent exotropia at distance only. Patient is now fixing with the right eye, showing that he can alternate well.
Patient with intermittent exotropia at both distance and near. Patient is fixing with the left eye. Note the outward deviation of the right eye.
Patient with intermittent exotropia at both distance and near. Patient is now fixing with the right eye, showing that she can alternate well.
Kushner classification of intermittent exotropia.
Management options for various types of intermittent exotropia.
 
 
 
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