Exotropia is a common type of strabismus that occurs when misaligned eyes deviate outward. Initially, an exotropia may only be seen when the patient is fatigued or ill. People with exotropia often experience crossed diplopia. Both parttime patching and observation are appropriate choices for the treatment of intermittent exotropia ixt in children aged 3 to 10 years, researchers conclude in. Squint clinic visual development what is amblyopia. Intermittent exotropia is the most common exodeviation and is found in 1% of the population.
Most common form of divergent strabismus onset before 5 years of age manifest during visual inattention fatigue illness daydreaming drowsiness upon awakening. Trial of overminus spectacle therapy for intermittent. Sensory exotropia occurs in the presence of poor vision. Diagnosis ou compound myopic astigmatism intermittent exotropia. The risks of exotropia are equal in both male and female. In the ideal situation, patching is gradually reduced and then stopped when the vision is equal in both eyes. Article 4 vision therapy management for intermittent. You may only notice one particular eye drifting out, or it may be either eye that deviates, known as an alternating exotropia. Part time patching of the nondeviating eye for four to six hours daily may convert an intermittent exotropia to a phoria. Intermittent exotropia ixt is the most common form of childhood exotropia and the most prevalent form of strabismus in some populations. Approximately 70% of children achieve this level of vision with patching treatment.
Management of intermittent exotropia of the divergence excess. The code is valid for the year 2020 for the submission of hipaacovered transactions. A squint, sometimes called strabismus, is a condition in which the eyes are misaligned one eye looks straight and the other eye looks outwards. Aug 03, 2016 cover test after 1 hour patching with pgp distance 2025 pd xt near 2025 pd xt 27. The longterm ontreatment effect of overminus treatment on distance intermittent exotropia ixt control score. Intermittent exotropia ixt is the most common form of childhood exotropia 1, 2 with an incidence of 32. Learn more about eye muscle surgery for exotropia and other types of strabismus. Plan of rx glasses reassure eom sx if required patch. Nov 14, 2014 intermittent exotropia xt is one of the most common types of childhood strabismus, occurring in. Exotropia a common type of strabismus is the outward deviation of an eye eye turns away from the nose. A randomized trial comparing parttime patching with observation for children 3 to 10 years of age with intermittent exotropia. The different types of acquired exotropia are intermittent exotropia, sensory exotropia, exotropia with neurologic causes and field defects, and consecutive exotropia. Unlike a pure phoria, intermittent exotropia spontaneously breaks.
Exotropia 1 exotropia in adults this material will help you understand exotropia and how to manage it. Transient intermittent exotropia is sometimes seen in the first 4 6 weeks of life and, if mild, can resolve spontaneously by 6 8 weeks of age. This is a topic that comes up day after day, week after week, month after month. Both parttime patching and observation are appropriate choices for the treatment of intermittent exotropia ixt in children aged 3 to 10 years, researchers conclude in a study published online. Intermittent exotropia caused by common near vision disorder. Observation versus occlusion therapy for intermittent. A case of intermittent exotropia by krishna banjade. Orthoptic treatment in the management of intermittent. Nov 04, 2015 intermittent exotropia outward drifting of either eye interspersed with periods of good alignment fig. Intermittent exotropia xt is a strabismus condition with outward drifting of either eye interspersed with periods of good alignment or orthotropia fig. Your child has been diagnosed with intermittent exotropia divergent squint. Untreated intermittent exotropia can change into permanent exotropia which finally results in vision loss. Although exotropia can occur at any age, younger children are majorly targeted. Oct 05, 2015 how to take on strabismus in adults often mislabeled a childhood disease, strabismus can be treated in adults, with visual and psychosocial benefits.
Intermittent exotropia ixt is the most common form of childhood exotropia 1, 2 and the most prevalent form of strabismus in some populations. Both surgical and nonsurgical management options are commonly prescribed, but there is controversy. A squint, sometimes called strabismus, is a condition in which the eyes. An officebased scale for assessing control in intermittent exotropia. It is the opposite of esotropia and usually involves more severe axis deviation than exophoria. Most common form of divergent strabismus onset before 5 years of age manifest during visual inattention fatigue illness. Management of intermittent exotropia of the divergence. Effect of patching versus observation on intermittent exotropia. Indicates that the study sponsor or investigator has submitted summary results information for a clinical study to clinicaltrials. How to take on strabismus in adults often mislabeled a childhood disease, strabismus can be treated in adults, with visual and psychosocial benefits. This is a common type of squint that usually develops in the preschool age group.
People with exotropia tend to favor the aligned eye, so vision in the eye turned outward can weaken, resulting in amblyopia. Know the causes, symptoms, treatment, prognosis and complications of exotropia. Esotropia and exotropia reference guide for clinicians prepared by the american optometric association consensus panel. Although the benefit is usually temporary, occlusion can be used to postpone surgical intervention in responsive patients 32. When the eye turns outward only some of the time, it is called intermittent exotropia. May 16, 2017 exotropia is a category of strabismus, a defect in which ones eyes deviate outward or away from each other. Basein prisms may aid control and relieve asthenopic symptoms in small comitant exodeviations of up to approximately 20 pd.
Diagnostic occlusion test in intermittent exotropia. Jun 21, 2016 trial of overminus spectacle therapy for intermittent exotropia ixt5 the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Intermittent exotropia is an exodeviation that is controlled part of the time by fusional convergence but becomes manifest some of the time. Patient was initially managed conservatively with patching and convergence exercises with good control of the deviation after only 3.
There is possibility of complications after surgery as well. Patching the dominant eye or alternate patching of either eye is performed to interrupt and reduce the progression of the exotropia. Certain conditions, such as third nerve palsy, thyroid ophthalmopathy, and iatrogenic trauma following retinal detachment surgery or endoscopic sinus surgery, could cause. Orthoptic treatment in the management of intermittent exotropia. To improve strength and vision in the misaligned eye, some. In many cases, the eye turn might only be visible during stressful situations or. T1 current nonsurgical management of intermittent exotropia. The effect of alternate occlusion on control of intermittent exotropia.
Exotropia also known as walleye or divergent strabismus differs from its opposite form, esotropia eye turns in toward nose, in that exotropic eyes point outward or away from the. Although intermittent exotropia may deteriorate with time, there are no. Find out why that is good news, see photos and learn all about successful diagnosis and treatment of intermittent exotropia. A case of intermittent exotropia by krishna banjade slideshare. Many people have a tendency for their eyes to drift out. Trial of overminus spectacle therapy for intermittent exotropia ixt5 the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Current nonsurgical management of intermittent exotropia. Exotropiaor an outward turning of the eyesis a common type of strabismus accounting for up to 25 percent of all ocular misalignment in early childhood.
Cover test after 1 hour patching with pgp distance 2025 pd xt near 2025 pd xt 27. Final diagnosis ou compound myopic astigmatism intermittent exotropia pseudo divergence type 28. Patching with observation for intermittent exotropia in children 12 to. Dec 15, 2009 a randomized trial comparing parttime patching with observation for children 3 to 10 years of age with intermittent exotropia.
Parttime patch therapy for treatment of intermittent exotropia full. This is, by far, the most common type of exodeviation. Exotropia may occur from time to time intermittent exotropia or may be constant. In a randomized trial we found parttime patching reduced the 6month risk of intermittent exotropia ixt deterioration, compared with observation. Although the benefit is usually temporary, occlusion can be used to postpone surgical intervention in responsive patients 18. Intermittent exotropia is a fairly common condition. Listing a study does not mean it has been evaluated by the u. Capturing the moment of fusion loss in intermittent exotropia. Intermittent exotropia most exotropia is intermittent and this means that the outward eye deviation or eye turn occurs only some of the time. However a more common scenario is that the vision in the amblyopic eye plateaus at 612 or 2040 level and patching is tapered off at this point. Does occlusion therapy improve control in intermittent. History of intermittent squint when child sick, tired, bright light, daydreaming. The first study will explore the natural history of intermittent exotropia by comparing patching against no treatment.
Patching the dominant eye or alternate patching of either eye is suggested to interrupt the process of suppression and to reduce the progression of the exotropia. Factors affecting residual exotropia after two muscle surgery for intermittent exotropia article pdf available in international journal of ophthalmology 107. Monocular eye closure may occur during exodeviation. The aim of this study was to evaluate the effectiveness of occlusion therapy in the control of intermittent exotropia ixt in children between 4 and 10 years in saudi arabia. Pdf factors affecting residual exotropia after two. N2 three common nonsurgical management strategies for childhood intermittent exotropia are observation alone, parttime patching, and overminus spectacles.
Intermittent divergent squint what is intermittent exotropia. Jan 01, 2002 i have never cured intermittent exotropia with patching, but i have read in the journals that some people are cured. Nov 15, 2018 the different types of acquired exotropia are intermittent exotropia, sensory exotropia, exotropia with neurologic causes and field defects, and consecutive exotropia. Intermittent exotropia outward drifting of either eye interspersed with periods of good alignment fig. Capturing the moment of fusion loss in intermittent exotropia john r. Patients in this study, which will have a threeyear followup period, are randomized to receive no treatment or to undergo six months of patching of one eye for two hours per day. A randomized trial comparing parttime patching with observation. Worth 4dot testing revealed diplopia at 6 feet and intermittent fusion at 16 inches.
Exotropia pictures,symptoms,causes,complications and. This is part 1 of a multipart series on how binocular vision affects reading ability. The pathogenesis of intermittent exotropia is unknown. Asadi et al orthoptic treatment in the management of intermittent exotropia 37 images which show two approximately equal images drawn or taken from two different angles and unification of these two images induces a 3d image to the viewer. Strabismus, whether it is newonset or a reappearance of childhood strabismus, can usually be successfully treated in adults. Contrary to the earlier practice of patching one eye for 24 hrs, it is now. The main objectives of this randomized trial comparing overminus lens treatment to nonoverminus spectacles without overminus or spectacles with plano lenses are to determine. Untreated exotropia can give rise to blurred vision and further increase the risk of permanent loss of vision. I initially spoke to james blaha after stumbling on his indiegogo campaign back in 20. Treatment options consist of vision therapy, patching, eyeglasses andor, very. Pdf factors affecting residual exotropia after two muscle. Continued parttime patching 24 hours per day helps the.
Intermittent exotropia xt is one of the most common types of childhood strabismus, occurring in. Exotropia is a form of strabismus where the eyes are deviated outward. Exotropia, or divergent squint, refers to an eye that turns or diverges outwards. These types of exotropia usually begin in early childhood. In our office, the parents are told of these possible problems following surgery, and that patching, special glasses, and even more than one operation may. New research sheds light on intermittent exotropia american. If exotropia affects both eyes, as a result of which the individual is unable to align both eyes, the condition is termed as convergence insufficiency or exophoria. Intermittent exodeviation usually occurs between 2 and 8 years of age, but may present any time between infancy and adulthood. Sometimes, exotropia is not completely treated with surgeries. Personally, i have never cured anybody by patching.
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