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Management of Exotropia in Childhood

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Practical Management of Pediatric Ocular Disorders and Strabismus

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Abstract

Exotropia is an outward deviation of the eye that may be constant or intermittent. Exotropia may be present in infancy (infantile or congenital exotropia) or may become manifest later in childhood or adulthood. Intermittent exotropia, the most common form, can be classified into (1) basic (distance = near deviation), (2) divergence excess (distance > near), (3) pseudodivergence excess (distance angle appears greater than near deviation) secondary to tenacious proximal fusion or a high accommodative convergence/accommodation (AC/A) ratio, and (4) convergence insufficiency (near > distance). This chapter will focus primarily on the diagnosis and management of intermittent exotropia. Subjective and objective assessment of the magnitude and patient’s control of the deviation guides management, which can be medical or surgical. Some controversy exists as to the most effective form of treatment and the optimal timing of interventions to promote and to maintain binocular visual development.

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Author information

Authors and Affiliations

  1. Cole Eye Institute, Cleveland Clinic Foundation, Beachwood, OH, USA

    Andreas Marcotty MD

  2. Cleveland Clinic Learner College of Medicine, Case Western Reserve University, 2000 Auburn Dr., Suite 100, Beachwood, OH, 44122, USA

    Andreas Marcotty MD

  3. Abrahamson Pediatric Eye Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 4008, Cincinnati, OH, 45229-3039, USA

    Virginia Miraldi Utz MD

  4. Department of Ophthalmology, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 4008, Cincinnati, OH, 45229-3039, USA

    Virginia Miraldi Utz MD

Authors
  1. Andreas Marcotty MD
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  2. Virginia Miraldi Utz MD
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Correspondence to Andreas Marcotty MD .

Editor information

Editors and Affiliations

  1. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Elias Traboulsi

  2. Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital, Cincinnati, Ohio, USA

    Virginia Utz

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Marcotty, A., Utz, V.M. (2016). Management of Exotropia in Childhood. In: Traboulsi, E., Utz, V. (eds) Practical Management of Pediatric Ocular Disorders and Strabismus. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2745-6_51

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  • DOI: https://doi.org/10.1007/978-1-4939-2745-6_51

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2744-9

  • Online ISBN: 978-1-4939-2745-6

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