Congenital Exotropia Clinical Presentation

Updated: Mar 22, 2016
  • Author: Mounir Bashour, MD, PhD, CM, FRCSC, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
  • Print
Presentation

History

By definition, children present when they are younger than 12 months with a constant outward deviation of the eyes.

Next:

Physical

Unlike other neurologic forms of exotropia, there should be no pupillary or lid involvement. Although craniofacial syndromes can be seen with congenital exotropia, there should be no ptosis or pupillary mydriasis (see Oculomotor Nerve Palsy).

The eyes should appear diverging with no limitation of adduction.

Over time, a preference may occur with one eye used consistently for fixation; then, the other eye will develop amblyopia.

As many as 60% of patients may develop oblique muscle dysfunction, dissociated vertical deviation, and amblyopia. Nystagmus is rare.

Previous
Next:

Causes

There is a familial predisposition suggestive of an autosomal dominant pattern with incomplete penetrance.

Previous