eMedicine Specialties > Ophthalmology > Extraocular Muscles

Exotropia, Acquired: Follow-up

Author: Neepa Thacker, MBBS, MS, DNB, FRCS, Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital, Mumbai, India
Coauthor(s): Frederico G Velez, MD, Clinical Instructor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, University of California at Los Angeles School of Medicine; Arthur L Rosenbaum, MD, Chief, Division of Pediatric Ophthalmology, Professor, Vice Chairman, Department of Ophthalmology, University of California at Los Angeles School of Medicine
Contributor Information and Disclosures

Updated: Sep 26, 2006

Follow-up

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.

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.

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.

Miscellaneous

Medicolegal Pitfalls

  • Failure to detect and promptly treat intermittent exotropia could result in constant exotropia with loss of binocularity and possible amblyopia
  • Failure to assess the neurologic condition in patients with exotropia associated with a neurologic disorder and to refer those patients for neurologic evaluation
 


More on Exotropia, Acquired

Overview: Exotropia, Acquired
Differential Diagnoses & Workup: Exotropia, Acquired
Treatment & Medication: Exotropia, Acquired
Follow-up: Exotropia, Acquired
Multimedia: Exotropia, Acquired
References
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References

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Further Reading

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Keywords

acquired exotropia, intermittent exotropia, sensory exotropia, exotropia with neurologic causes and field defects, consecutive exotropia, exodeviation, strabismus

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Contributor Information and Disclosures

Author

Neepa Thacker, MBBS, MS, DNB, FRCS, Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital, Mumbai, India
Disclosure: Nothing to disclose.

Coauthor(s)

Frederico G Velez, MD, Clinical Instructor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, University of California at Los Angeles School of Medicine
Frederico G Velez, MD is a member of the following medical societies: American Academy of Ophthalmology
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.

Medical Editor

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, American College of Surgeons, and North Carolina Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

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.

CME Editor

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.

 
 
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