eMedicine Specialties > Ophthalmology > Extraocular Muscles

Exotropia, Congenital: Follow-up

Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Coauthor(s): C Corina Gerontis, MD, Consulting Staff, Departments of Pediatrics and Ophthalmology, Schneider Children's Hospital/Long Island Jewish Medical Center
Contributor Information and Disclosures

Updated: Oct 31, 2008

Follow-up

Further Outpatient Care

  • A child with any form of strabismus is at risk of losing vision (amblyopia). Since these children present at a nonverbal age, it is imperative that a pediatric ophthalmologist screen and follow the visual status during the critical years of visual development.

Deterrence/Prevention

  • Amblyopia prevention by frequent ophthalmic examinations

Complications

  • Loss of depth perception
  • Amblyopia (loss of vision)
  • Neurological consequences if underlying neurologic diagnosis is undetected

Prognosis

  • Good restoration of binocular vision if detected and treated in time
  • Vision maintained if amblyopia is detected and treated while still at the critical age of visual development

Patient Education

  • Familial predisposition for siblings and offspring to develop this or other forms of strabismus
  • Awareness of potential loss of vision, loss of depth perception, and muscle restriction or shortening
  • Possible need for amblyopia treatment (patching)
  • Possible need for repeated surgical procedures

Miscellaneous

Medicolegal Pitfalls

  • Since there is a high association of neurologic or chromosomal abnormalities, consultation with a pediatric ophthalmologist is essential for the differential diagnosis of isolated strabismus versus systemic involvement.
  • Any child with possible ocular problems should be seen by a specialist. Eye problems in children may lead to irreversible blindness if not corrected; they do not just go away. Appropriate diagnosis and treatment by a pediatric ophthalmologist prevents possible lifelong visual handicaps.
 


More on Exotropia, Congenital

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

  1. Hunter DG, Kelly JB, Buffenn AN, et al. Long-term outcome of uncomplicated infantile exotropia. J AAPOS. Dec 2001;5(6):352-6. [Medline].

  2. Saunders RA, Trivedi RH. Sensory results after lateral rectus muscle recession for intermittent exotropia operated before two years of age. J AAPOS. Apr 2008;12(2):132-5. [Medline].

  3. Biglan AW, Davis JS, Cheng KP, et al. Infantile exotropia. J Pediatr Ophthalmol Strabismus. Mar-Apr 1996;33(2):79-84. [Medline].

  4. Brodsky MC, Baker RS, Hamed LM. Pediatric Neuro-ophthalmology. 1996.

  5. Hunter DG, Ellis FJ. Prevalence of systemic and ocular disease in infantile exotropia: comparison with infantile esotropia. Ophthalmology. Oct 1999;106(10):1951-6. [Medline].

  6. Matsuo T, Yamane T, Ohtsuki H. Heredity versus abnormalities in pregnancy and delivery as risk factors for different types of comitant strabismus. J Pediatr Ophthalmol Strabismus. Mar-Apr 2001;38(2):78-82. [Medline].

  7. Mohney BG, Huffaker RK. Common forms of childhood exotropia. Ophthalmology. Nov 2003;110(11):2093-6. [Medline].

  8. von Noorden GK. Binocular Vision and Binocular Motility: Theory and Management of Strabismus. 1996.

  9. Wright KW, Buckley EG, Del Monte MA. Pediatric Ophthalmology and Strabismus. 1995.

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Further Reading

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Keywords

congenital exotropia, XT, strabismus

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Contributor Information and Disclosures

Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

C Corina Gerontis, MD, Consulting Staff, Departments of Pediatrics and Ophthalmology, Schneider Children's Hospital/Long Island Jewish Medical Center
C Corina Gerontis, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Gerhard W Cibis, MD, Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas, Kansas City
Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological 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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