Intermittent exotropia in the right eye What are the signs of intermittent exotropia? People with intermittent exotropia may experience an outward drift only occasionally, such as when they are very tired, feeling sick, or after drinking alcohol, despite their efforts to refocus. Some patients may experience double vision diplopia ; others say that they can feel that an eye is misaligned, even though they do not see anything unusual. Others are unaware that an eye is turning, unless another person mentions it to them. Why does my child, who has intermittent exotropia, close one eye frequently?
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Intermittent exotropia in the right eye What are the signs of intermittent exotropia? People with intermittent exotropia may experience an outward drift only occasionally, such as when they are very tired, feeling sick, or after drinking alcohol, despite their efforts to refocus. Some patients may experience double vision diplopia ; others say that they can feel that an eye is misaligned, even though they do not see anything unusual.
Others are unaware that an eye is turning, unless another person mentions it to them. Why does my child, who has intermittent exotropia, close one eye frequently? Children with intermittent exotropia commonly close or squint one eye at times, especially when they are exposed to bright sunlight. The exact reason for this is not clear.
If the exotropia becomes more constant, then the deviating can become under-used and amblyopia reduced vision may develop. It is important therefore to have regular vision checks with your orthoptist. If amblyopia develops your orthoptist may recommend patching or an atropine regime. Of course, if your child is shortsighted or longsighted this should be corrected with glasses.
Can anything be done to keep intermittent exotropia from getting worse? Keeping the child as well rested and healthy as possible will help. Feeling sick or having a fever may cause the intermittent exotropia to temporarily occur more frequently. Your orthoptist or ophthalmologist may recommend eye exercises or minus concave lenses if they feel your child will benefit. Minus lenses glasses with a prescription such as -1 or -2 etc. As the eyes focus accommodate they also converge turn in which helps to control the divergent angle.
Eventually the child would be weaned off the glasses in the hope that they can maintain control of the exotropia themselves. Concave lenses controlling an exotropia In cases where the exotropia persists after exercises and minus lenses, then strabismus squint surgery may be required. Children who undergo surgery at an older age may have better outcomes and treatment.
Exercises or minus lenses can help to keep their eyes working together until they are an optimum age for surgery. Your orthoptist and ophthalmologist will discuss the ideal timing of surgery for your situation. What is binocular vision? It is only possible when the eyes are straight and not when the exotropia is present.
Among other benefits, binocular vision is necessary for normal depth perception, or "3-D vision". Children who are capable of maintaining binocular vision are also less likely to develop amblyopia.
What is sensory or deprivation exotropia? Exotropia in an eye with very poor vision is called sensory exotropia. In this case, the eye with low vision is unable to work together with the other eye, and therefore, the poorly-seeing eye may have a tendency to drift outward. Sensory exotropia may occur at any age. Of course, if the visual problem is treatable, it should be addressed as soon as possible. Surgery to cosmetically straighten the eye may be possible. What age is best for exotropia surgery?
Age is not the main determining factor for exotropia surgery. The surgery is appropriate when exotropia is worsening and is present for the majority of the time. However older children may have better long term outcomes.
A common form of exotropia is known as " convergence insufficiency " that responds well to orthoptic vision therapy including exercises. This disorder is characterized by an inability of the eyes to work together when used for near viewing, such as reading. Instead of the eyes focusing together on the near object, one deviates outward. Consecutive exotropia arises after an initial esotropia. Most often it results from surgical overcorrection of the initial esotropia. It can be addressed with further surgery or with vision therapy; vision therapy has shown promising results if the consecutive exotropia is intermittent, alternating, and of small magnitude. This consists of visual exercises.
Intermittent Distance Exotropia (IDEX)
Divergent Strabismus: Classification, Causes, Symptoms, Diagnosis, Treatment and Complications