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Acquired Exotropia Workup

  • Author: Neepa Thacker, MBBS, MS, DNB, FRCS; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Mar 26, 2014
 

Laboratory Studies

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  • Laboratory tests are not usually required, except for those routinely performed prior to surgery.
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Imaging Studies

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  • Imaging studies are not routinely required, although they may be beneficial for patients with certain conditions (eg, craniosynostosis, suspected abnormalities of the pulley systems).
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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; Head, Department of Pediatric Ophthalmology and Strabismus, Lotus Eye Hospital, India

Disclosure: Nothing to disclose.

Coauthor(s)

Arthur L Rosenbaum, MD 

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

Disclosure: Nothing to disclose.

Federico G Velez, MD Assistant Clinical Professor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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

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, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Michael J Bartiss, OD, MD Medical Director, Ophthalmology, Family Eye Care of the Carolinas and Surgery Center of Pinehurst

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

Disclosure: Nothing to disclose.

References
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  2. Dawson EL, Sainani A, Lee JP. Does botulinum toxin have a role in the treatment of secondary strabismus?. Strabismus. 2005 Jun. 13(2):71-3. [Medline].

  3. Choi MY, Hyung SM, Hwang JM. Unilateral recession-resection in children with exotropia of the convergence insufficiency type. Eye. 2005 Dec 2. [Medline].

  4. Figueira EC, Hing S. Intermittent exotropia: comparison of treatments. Clin Experiment Ophthalmol. 2006 Apr. 34(3):245-51. [Medline].

  5. Kim C, Hwang JM. Largest angle to target' in surgery for intermittent exotropia. Eye. 2005 Jun. 19(6):637-42. [Medline].

  6. Burian HM. Exodeviations: Their classifications, diagnosis, and treatment. Am J Ophthalmol. 1996. 62:1161.

  7. Burian HM, Franceschetti AT. Evaluation of diagnostic methods for the classifications of exodeviations. Am J Ophthalmol. 1971. 71:34.

  8. Burke MJ. Intermittent exotropia. Int Ophthalmol Clin. 1985 Winter. 25(4):53-68. [Medline].

  9. Caltrider N, Jampolsky A. Overcorrecting minus lens therapy for treatment of intermittent exotropia. Ophthalmology. 1983 Oct. 90(10):1160-5. [Medline].

  10. Choi DG, Rosenbaum AL. Medial rectus resection(s) with adjustable suture for intermittent exotropia of the convergence insufficiency type. J AAPOS. 2001 Feb. 5(1):13-7. [Medline].

  11. Cooper E. The surgical management of secondary exotropia. Trans Am Acad Ophthalmol Otolaryngol. 1961. 65:595.

  12. Duane A. A new classification of the motor anomalies based upon physiological principles together with their symptoms, diagnosis, and treatment. Am Ophthalmol Otolaryngol. 1897. 6:84.

  13. Eustace P, Wesson ME, Drury DJ. The effect of illumination of intermittent divergent squint of the divergence excess type. Trans Ophthalmol Soc U K. 1973. 93(0):559-70. [Medline].

  14. Friedman Z, Neumann E, Hyams SW, Peleg B. Ophthalmic screening of 38,000 children, age 1 to 2 1/2 years, in child welfare clinics. J Pediatr Ophthalmol Strabismus. 1980 Jul-Aug. 17(4):261-7. [Medline].

  15. Jampolsky A. Ocular divergence mechanisms. Trans Am Ophthalmol Soc. 1970. 68:730-822. [Medline].

  16. Jampolsky A. Strabismus reoperation techniques. Trans Am Acad Ophthalmol Otolaryngol. 1975 Sep-Oct. 79(5):704-17. [Medline].

  17. Jampolsky A. Treatment of exodeviations. Trans New Orleans Acad Ophthalmol. 1986. 34:201-34. [Medline].

  18. Jenkins R. Demographics: Geographic variations in the prevalence and management of exotropia. Am Orthopt J. 1992. 42:82.

  19. Kushner BJ. Exotropic deviations. A functional classification and approach to treatment. Am J Orthop. 1988. 38:81.

  20. Kushner BJ. Selective surgery for intermittent exotropia based on distance/near differences. Arch Ophthalmol. 1998 Mar. 116(3):324-8. [Medline].

  21. Kushner BJ. The distance angle to target in surgery for intermittent exotropia. Arch Ophthalmol. 1998 Feb. 116(2):189-94. [Medline].

  22. Parks MM. Concomitant exodeviations. In: Ocular Motility and Strabismus. Hagerstown, Md:. Harper & Row. 1975:113.

  23. Rosenbaum AL. Exodeviations. In: Current Concepts in Pediatric Ophthalmology and Strabismus. Ann Arbor:. University of Michigan. 1993:41.

  24. Rosenbaum AL, Stathacopoulus RA. Subjective and objective criteria for recommending surgery on intermittent exotropia. Am Orthopt J. 1992. 42:46.

  25. Santiago AP, Ing MR, Kushner BJ, Rosenbaum AL. Intermittent exotropia. In: Clinical Strabismus Management: Principles and Surgical Techniques. WB Saunders Co. 1999.

  26. Von Noorden GK. Exodeviations. In: Binocular Vision and Ocular Motility: Theory and Management of Strabismus. 5th ed. St Louis:. Mosby Year Book. 1996:341.

  27. Wiggins RE, von Noorden GK. Monocular eye closure in sunlight. J Pediatr Ophthalmol Strabismus. 1990 Jan-Feb. 27(1):16-20; discussion 21-2. [Medline].

  28. Wirtschafter JD, Bourassa CM. Binocular facilitation of discomfort with high luminances. Arch Ophthalmol. 1966 May. 75(5):683-8. [Medline].

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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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