exotropia

Summary

Summary: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction.

Top Publications

  1. Mohney B. Common forms of childhood strabismus in an incidence cohort. Am J Ophthalmol. 2007;144:465-7 pubmed
    ..The medical records of all Olmsted County, Minnesota, residents younger than 19 years diagnosed with esotropia, exotropia, or hypertropia from January 1, 1985 through December 31, 1994, were reviewed...
  2. Kim S, Choi Y. Effects of unilateral lateral rectus recession according to the tendon width in intermittent exotropia. Eye (Lond). 2006;20:785-8 pubmed
    ..effect of unilateral lateral rectus recession for each millimeter according to the tendon width in intermittent exotropia. A total of 37 patients (37 eyes) of 7 to 11 years of age with basic-type intermittent exotropia and a deviation ..
  3. Brodsky M, Graf M, Kommerell G. The reversed fixation test: a diagnostic test for dissociated horizontal deviation. Arch Ophthalmol. 2005;123:1083-7 pubmed
    ..The reversed fixation test is necessary to establish the diagnosis of dissociated horizontal deviation. ..
  4. Hatt S, Leske D, Adams W, Kirgis P, Bradley E, Holmes J. Quality of life in intermittent exotropia: child and parent concerns. Arch Ophthalmol. 2008;126:1525-9 pubmed publisher
    To identify specific health-related quality-of-life (HRQOL) concerns for children with intermittent exotropia (IXT) and their parents. Twenty-four children aged 5 to 17 years with IXT and 1 parent for each child were recruited...
  5. Saxena R, Kakkar A, Menon V, Sharma P, Phuljhele S. Evaluation of factors influencing distance stereoacuity on Frisby-Davis Distance Test (FD2) in intermittent exotropia. Br J Ophthalmol. 2011;95:1098-101 pubmed publisher
    To evaluate the factors affecting the restoration of stereoacuity after surgery in cases of intermittent exotropia. Thirty consecutive patients of intermittent exotropia X (T) scheduled for surgical intervention underwent preoperative ..
  6. Nusz K, Mohney B, Diehl N. The course of intermittent exotropia in a population-based cohort. Ophthalmology. 2006;113:1154-8 pubmed
    ..the change in the angle of deviation in an incidence cohort of pediatric patients diagnosed with intermittent exotropia during a 20-year period. Retrospective, population-based observational study...
  7. Eibschitz Tsimhoni M, Archer S, Furr B, Del Monte M. Current concepts in the management of concomitant exodeviations. Compr Ophthalmol Update. 2007;8:213-23 pubmed
    Intermittent exotropia is the most common form of divergent strabismus. Treatment is indicated with increasing tropia phase to preserve or restore binocular function and restore/reconstruct normal ocular alignment...
  8. Kim C, Hwang J. 'Largest angle to target' in surgery for intermittent exotropia. Eye (Lond). 2005;19:637-42 pubmed
    To evaluate the safety of the approach based on the notion that the surgical dose for intermittent exotropia should be based on the largest angle ever measured. Prospective case series of 33 patients...
  9. Buck D, Hatt S, Haggerty H, Hrisos S, Strong N, Steen N, et al. The use of the Newcastle Control Score in the management of intermittent exotropia. Br J Ophthalmol. 2007;91:215-8 pubmed
    To evaluate the use of the Newcastle Control Score (NCS) in the management of intermittent exotropia (X(T)). Children aged <11 years with X(T) had an assessment of NCS as part of routine management...

More Information

Publications62

  1. Jethani J. Convergence insufficiency: randomized clinical trial. Arch Ophthalmol. 2005;123:1760; author reply 1760-1 pubmed
  2. Hatt S, Leske D, Yamada T, Bradley E, Cole S, Holmes J. Development and initial validation of quality-of-life questionnaires for intermittent exotropia. Ophthalmology. 2010;117:163-168.e1 pubmed publisher
    ..initial validation of patient-derived, health-related quality-of-life (HRQOL) questionnaires for intermittent exotropia (IXT). Cross-sectional study...
  3. Park K, Kim S. Clinical characteristics of patients that experience different rates of exodrift after strabismus surgery for intermittent exotropia and the effect of the rate of exodrift on final ocular alignment. J AAPOS. 2013;17:54-8 pubmed publisher
    ..the ocular motility factors associated with the rate of exodrift after surgical correction of intermittent exotropia and to determine whether the rate had an effect on the subsequent postoperative ocular alignment...
  4. Buck D, Clarke M, Haggerty H, Hrisos S, Powell C, Sloper J, et al. Grading the severity of intermittent distance exotropia: the revised Newcastle Control Score. Br J Ophthalmol. 2008;92:577 pubmed publisher
  5. Hong S, Chang Y, Han S. Full tendon transposition augmented with posterior intermuscular suture and recession--resection surgery. Korean J Ophthalmol. 2006;20:254-5 pubmed
    To report an effect of the full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery, for the patient with monocular elevation deficiency (MED) and large exotropia.
  6. Millán T, de Carvalho K, Minguini N. Results of monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus. Clinics (Sao Paulo). 2009;64:303-8 pubmed
    ..Patients were divided into group 1- esotropia and group 2 -exotropia. The postoperative follow-up was at 6 months, when the residual deviation was evaluated...
  7. Hahm I, Yoon S, Baek S, Kong S. The clinical course of recurrent exotropia after reoperation for exodeviation. Korean J Ophthalmol. 2005;19:140-4 pubmed
    To determine the clinical course of recurrent exotropia after a secondary operation for exotropia...
  8. Chia A, Seenyen L, Long Q. A retrospective review of 287 consecutive children in singapore presenting with intermittent exotropia. J AAPOS. 2005;9:257-63 pubmed
    Intermittent exotropia, X(T), is a relatively common form of strabismus among children in Singapore. The purpose of this study is to see how children presenting with this condition fared during a period of 5 years...
  9. Piano M, O Connor A. Conservative management of intermittent distance exotropia: a review. Am Orthopt J. 2011;61:103-16 pubmed publisher
    Intermittent distance exotropia is difficult to conservatively manage, with techniques varying widely between institutions...
  10. Buck D, Powell C, Cumberland P, Davis H, Dawson E, Rahi J, et al. Presenting features and early management of childhood intermittent exotropia in the UK: inception cohort study. Br J Ophthalmol. 2009;93:1620-4 pubmed publisher
    To investigate factors associated with early management of intermittent exotropia (X(T)) in hospital eye departments in the UK in a prospective cohort study...
  11. Paula J, Ibrahim F, Martins M, Bicas H, Velasco e Cruz A. Refractive error changes in children with intermittent exotropia under overminus lens therapy. Arq Bras Oftalmol. 2009;72:751-4 pubmed
    Intermittent exotropia may be decreased by stimulation of accommodative convergence...
  12. Mojon Azzi S, Kunz A, Mojon D. The perception of strabismus by children and adults. Graefes Arch Clin Exp Ophthalmol. 2011;249:753-7 pubmed publisher
    ..It remains controversial if esotropia or exotropia is perceived more negatively...
  13. Mohney B, McKenzie J, Capo J, Nusz K, Mrazek D, Diehl N. Mental illness in young adults who had strabismus as children. Pediatrics. 2008;122:1033-8 pubmed publisher
    ..The medical records of children (<19 years) who were diagnosed as having esotropia (N = 266) or exotropia (N = 141) while residents of Olmsted County, Minnesota, between January 1, 1985, and December 31, 1994, were ..
  14. Serrano Pedraza I, Manjunath V, Osunkunle O, Clarke M, Read J. Visual suppression in intermittent exotropia during binocular alignment. Invest Ophthalmol Vis Sci. 2011;52:2352-64 pubmed publisher
    To investigate the cortical mechanisms that prevent diplopia in intermittent exotropia (X(T)) during binocular alignment (orthotropia). The authors studied 12 X(T) patients aged 5 to 22 years...
  15. Ekdawi N, Nusz K, Diehl N, Mohney B. Postoperative outcomes in children with intermittent exotropia from a population-based cohort. J AAPOS. 2009;13:4-7 pubmed publisher
    To describe the long-term surgical outcomes in a population-based cohort of children with intermittent exotropia. The medical records of all children (<19 years) who were diagnosed with intermittent exotropia as residents of Olmsted ..
  16. Adams W, Leske D, Hatt S, Mohney B, Birch E, Weakley D, et al. Improvement in distance stereoacuity following surgery for intermittent exotropia. J AAPOS. 2008;12:141-4 pubmed
    To evaluate whether distance stereoacuity improves following surgery for intermittent exotropia using the Frisby Davis Distance (FD2) and Distance Randot stereotests...
  17. Celebi S, Kükner A. Large bilateral lateral rectus recession in large angle divergence excess exotropia. Eur J Ophthalmol. 2001;11:6-8 pubmed
    Classic teaching suggests that surgery for intermittent exotropia should be based on distance/near differences. True divergence excess exotropia should be treated with symmetric lateral rectus recession...
  18. Chia A, Roy L, Seenyen L. Comitant horizontal strabismus: an Asian perspective. Br J Ophthalmol. 2007;91:1337-40 pubmed
    ..493 children (72%) were exotropic, the majority (92%) of whom had intermittent exotropia, X(T). The divergence excess type X(T) was most common (59.5%), followed by basic (29...
  19. Oh J, Hwang J. Survival analysis of 365 patients with exotropia after surgery. Eye (Lond). 2006;20:1268-72 pubmed
    Few reports have included large numbers of exotropia patients. Thus, we undertook this study to perform a survival analysis of over 350 patients with exotropia and to determine which factors might affect the outcome of exotropia surgery...
  20. Yazdian Z, Ghiassi G. Re-recession of the lateral rectus muscles in patients with recurrent exotropia. J AAPOS. 2006;10:164-7 pubmed
    ..and ocular motility after surgical rerecession of the lateral rectus (LR) muscles as a treatment for recurrent exotropia (XT)...
  21. Menon V, Singla M, Saxena R, Phulijele S. Comparative study of unilateral and bilateral surgery in moderate exotropia. J Pediatr Ophthalmol Strabismus. 2010;47:288-91 pubmed publisher
    To evaluate the surgical outcome of unilateral versus bilateral rectus recession for the correction of moderate exotropia. This was a prospective study of 20 consecutive cases of intermittent exotropia ranging from 15 to 25 prism ..
  22. Chia A, Seenyen L, Long Q. Surgical experiences with two-muscle surgery for the treatment of intermittent exotropia. J AAPOS. 2006;10:206-11 pubmed
    The surgical management of intermittent exotropia, or X(T), remains a challenge. Not only are some quoted success rates relatively low (40-83%), but the outcome is notoriously unpredictable with a tendency to exotropic drift over time...
  23. Chae S, Chun B, Kwon J. The effect of unilateral medial rectus muscle resection in patients with recurrent exotropia. Korean J Ophthalmol. 2008;22:174-7 pubmed publisher
    To investigate the effect of unilateral medial rectus muscle resection for recurrent exotropia after bilateral lateral rectus muscle recession for intermittent exotropia
  24. Kordic H, Sturm V, Landau K. [Long-term follow-up after surgery for exodeviation]. Klin Monbl Augenheilkd. 2009;226:315-20 pubmed publisher
    ..The criteria for patients with intermittent exotropia and decompensating exophoria after one year and in the long-term follow-up were determined as follows: very good:..
  25. Hatt S, Mohney B, Leske D, Holmes J. Variability of control in intermittent exotropia. Ophthalmology. 2008;115:371-376.e2 pubmed
    Assessing control is thought to be important in the management of intermittent exotropia, including the decision to perform surgery...
  26. Saleem Q, Cheema A, Tahir M, Dahri A, Sabir T, Niazi J. Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia. BMC Res Notes. 2013;6:257 pubmed publisher
    The purpose of this study was to measure the success rate of unilateral lateral rectus recession and medial rectus resection in primary exotropia.
  27. Yang H, Han S, Hwang J, Kim Y, Jeong C, Kim K. Assessment of binocular alignment using the three-dimensional Strabismus Photo Analyzer. Br J Ophthalmol. 2012;96:78-82 pubmed publisher
    ..Thirty-two subjects with exotropia, 30 subjects with esotropia and 38 orthotropic subjects were included...
  28. Kothari M, Balankhe S, Gawade R, Toshnival S. Comparison of psychosocial and emotional consequences of childhood strabismus on the families from rural and urban India. Indian J Ophthalmol. 2009;57:285-8 pubmed publisher
    ..The quality-of-life instrument can be used as part of the clinical examination for strabismic children. ..
  29. Hatt S, Mohney B, Leske D, Holmes J. Variability of stereoacuity in intermittent exotropia. Am J Ophthalmol. 2008;145:556-561 pubmed publisher
    Distance stereoacuity is used to monitor deterioration of intermittent exotropia (IXT), but variability of stereoacuity has not been studied rigorously...
  30. Laird P, Hatt S, Leske D, Holmes J. Distance stereoacuity in prism-induced convergence stress. J AAPOS. 2008;12:370-4 pubmed publisher
    ..stereotests (FD2) is affected more than random dot tests (DR), in contrast to previous findings in intermittent exotropia. There appear to be different mechanisms for decreased stereoacuity in intermittent exotropia and under ..
  31. Koklanis K, Georgievski Z. Recurrence of intermittent exotropia: factors associated with surgical outcomes. Strabismus. 2009;17:37-40 pubmed publisher
    The surgery of choice for intermittent exotropia (XT) continues to be debated, with little evidence that one procedure provides a more successful outcome than the other in the longer term...
  32. Serrano Pedraza I, Clarke M, Read J. Single vision during ocular deviation in intermittent exotropia. Ophthalmic Physiol Opt. 2011;31:45-55 pubmed publisher
    Intermittent exotropia is a common oculomotor anomaly where one eye intermittently deviates outwards. Patients with this type of strabismus are often not aware of the exodeviation and do not usually experience diplopia...
  33. Pellanda N, Mojon D. Combined horizontal rectus muscle minimally invasive strabismus surgery for exotropia. Can J Ophthalmol. 2010;45:363-7 pubmed publisher
    To evaluate combined horizontal rectus muscle minimally invasive strabismus surgery (MISS) for exotropia. Case series...
  34. Lim S, Hong J, Kim M. Prognostic factors for recurrence with unilateral recess-resect procedure in patients with intermittent exotropia. Eye (Lond). 2011;25:449-54 pubmed publisher
    To evaluate the prognostic factors, particularly age at the time of surgery, for recurrence after unilateral medial rectus resection and lateral rectus recession (R&R) procedures in patients with intermittent exotropia, or X(T).
  35. Govindan M, Mohney B, Diehl N, Burke J. Incidence and types of childhood exotropia: a population-based study. Ophthalmology. 2005;112:104-8 pubmed
    To determine the incidence and types of childhood exotropia in a defined population. Retrospective, population-based cohort...
  36. Yildirim C, Altinsoy H. Distance alternate-letter suppression test for objective assessment of sensorial status in intermittent exotropia. Eur J Ophthalmol. 2000;10:4-10 pubmed
    To investigate the value of distance alternate-letter suppression testing in the objective assessment of fusional control of intermittent exotropia.
  37. Kim H, Jung M, Kim S. Exotropia caused by pit viper snakebite. J AAPOS. 2009;13:424-5 pubmed publisher
    ..In previously reported cases, the medial rectus muscle has been the most frequently involved. We report the first case of a pit viper snakebite resulting in comitant exotropia without obvious paralytic features.
  38. Kim S, Cho Y, Park C, Uhm C. The ultrastructural changes of tendon axonal profiles of medial rectus muscles according to duration in patients with intermittent exotropia. Eye (Lond). 2008;22:1076-81 pubmed publisher
    ..investigate the ultrastructural changes of tendon axonal profiles of medial recti in patients with intermittent exotropia at different ages...
  39. Lee K, Shin K, Kim Y, Choi M. Comparison of outcomes of unilateral lateral rectus recession for exotropia between first and second operations. Korean J Ophthalmol. 2011;25:329-33 pubmed publisher
    ..compare the outcomes of unilateral lateral rectus recession between the first operation and second operation for exotropia. Thirty-two patients who underwent unilateral lateral rectus recession for exotropia of 15 to 20 prism diopters (..
  40. Choi J, Kim S, Yu Y. Initial postoperative deviation as a predictor of long-term outcome after surgery for intermittent exotropia. J AAPOS. 2011;15:224-9 pubmed publisher
    ..the relationship between initial postoperative deviation and long-term results after surgery for intermittent exotropia. A nonrandomized, retrospective case series...
  41. Leow P, Ko S, Wu P, Chan C. Exotropic drift and ocular alignment after surgical correction for intermittent exotropia. J Pediatr Ophthalmol Strabismus. 2010;47:12-6 pubmed publisher
    To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia.
  42. Hatt S, Gnanaraj L. Interventions for intermittent exotropia. Cochrane Database Syst Rev. 2006;:CD003737 pubmed
    The clinical management of intermittent exotropia has been discussed frequently in the literature, but there is a lack of clarity regarding the indications for intervention, the most effective type and if there is a time point at which ..
  43. Lee H, Kim S. Bilateral lateral rectus recession considering the tendon width in intermittent exotropia. Eye (Lond). 2009;23:1808-11 pubmed publisher
    ..rectus muscle can be a useful indicator of the effect of unilateral lateral rectus recession in intermittent exotropia. The aim of this study was to determine whether the tendon width of lateral rectus would be useful for ..
  44. Watts P, Tippings E, Al Madfai H. Intermittent exotropia, overcorrecting minus lenses, and the Newcastle scoring system. J AAPOS. 2005;9:460-4 pubmed
    ..the Newcastle Control Score (NCS) could be used to indicate a successful outcome in patients with intermittent exotropia that were treated with minus lenses...
  45. Spierer O, Spierer A, Glovinsky J, Ben Simon G. Moderate-angle exotropia: a comparison of unilateral and bilateral rectus muscle recession. Ophthalmic Surg Lasers Imaging. 2010;41:355-9 pubmed publisher
    ..surgical outcome of unilateral lateral rectus recession and bilateral lateral rectus recession in moderate-angle exotropia (< or = 30 prism diopters [PD])...
  46. Sharma P, Saxena R, Narvekar M, Gadia R, Menon V. Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia. Indian J Ophthalmol. 2008;56:121-5 pubmed
    To evaluate the role of distance and near stereoacuity and fusional vergence in patients with intermittent exotropia [X(T)] and their change after surgery...
  47. Romanchuk K, Dotchin S, Zurevinsky J. The natural history of surgically untreated intermittent exotropia-looking into the distant future. J AAPOS. 2006;10:225-31 pubmed
    We studied patients with distance intermittent exotropia with at least 5 years follow-up before any surgical therapy, to determine how often amblyopia developed, whether there was progressive worsening in the angle or control of the ..
  48. Koo N, Lee Y, Lee S. Clinical study for the undercorrection factor in intermittent exotropia. Korean J Ophthalmol. 2006;20:182-7 pubmed
    The surgical technique for intermittent exotropia [X(T)] is quite simple. However, in many cases, the condition recurs due to any one of a number of causes, including undercorrection...
  49. Jeoung J, Lee M, Hwang J. Bilateral lateral rectus recession versus unilateral recess-resect procedure for exotropia with a dominant eye. Am J Ophthalmol. 2006;141:683-8 pubmed
    ..lateral rectus recession and unilateral recess-resect (RR) procedure on the nondominant eye for the patients of exotropia with a dominant fixating eye. Prospective randomized comparative clinical trial...
  50. Mohney B, Holmes J. An office-based scale for assessing control in intermittent exotropia. Strabismus. 2006;14:147-50 pubmed
    Although intermittent exotropia may deteriorate with time, there are no widely accepted criteria for measuring progression in this disorder...
  51. Wu H, Sun J, Xia X, Xu L, Xu X. Binocular status after surgery for constant and intermittent exotropia. Am J Ophthalmol. 2006;142:822-6 pubmed
    To investigate whether constant exotropia patients with a previous history of intermittent exotropia X(T), like X(T) patients, can achieve postoperative bifixation, and whether they have a better postoperative sensory outcome than those ..
  52. Asjes Tydeman W, Groenewoud H, Van Der Wilt G. Timing of surgery for primary exotropia in children. Strabismus. 2007;15:95-101 pubmed
    To compare the postoperative alignment and sensory functions in patients with primary exotropia who had been operated at an early age (< 7 years) with those in patients who had been operated at an older age (> 7 years)...
  53. Rajavi Z, Mohammad Rabei H, Ramezani A, Heidari A, Daneshvar F. Refractive effect of the horizontal rectus muscle recession. Int Ophthalmol. 2008;28:83-8 pubmed
    ..To determine refractive and corneal topographic changes after horizontal rectus muscles recession...