Exotropia is a misalignment of the eyes in which the eyes deviate outward. Though exotropia occurs less frequently than esotropia ("crossed eyes"), it is still a common form of strabismus. Exotropia may occur only when the child is daydreaming, tired, or sick. Parents often notice that the child squints one eye in bright sunlight.

Intermittent Exotropia is the most common exodeviation in childhood. It can occur at any age, but most frequently between the ages of two and four years of age. The size of the deviation, its frequency, and the child's ability to control the drifting are important factors in determining treatment. The doctor may ask you to quantitate the amount of drifting that you see at home.

Convergence Insufficiency occurs when the near deviation is greater than the distance deviation. These children may complain of difficulty with reading and near work, and become more symptomatic during times of stress (ex.final exams).

Amblyopia, or "lazy eye", may develop with exotropia, although it is less common than with esotropia, as the deviation is usually intermittent. Children learn to suppress the double vision associated with exotropia so effectively that the deviating eye gradually loses vision.

The treatment for exotropia may include glasses to improve visual acuity, as well as, "over minus" corrections to improve alignment. Patching may be required in cases of amblyopia, or a strong eye preference. Prisms are more commonly used in adult patients. Convergence exercises have also been shown to improve control. Surgery to adjust the eye muscles is often recommended in cases of constant and intermittent exotropia. The goal of surgery is to get the eyes as straight as possible so that no residual deviation is visible and binocular vision can develop.

Exotropia Left, Child

Exotropia Right, Adult

9/25/09