Exotropia

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Exotropia is the outward deviation of the eyes and is a type of strabismus or eye misalignment. It commonly appears in children aged 2 to 4 years, but can occur at any age.

The primary symptom of exotropia is a noticeable outward deviation of the eyes. Sometimes it may be noticeable only when your child is tired or not feeling well. It is more apparent when the child looks into the distance, rather than at objects nearby. The child may squint or rub one of the eyes and also may close one eye in bright sunlit environments.

A pediatric ophthalmologist will perform all necessary tests to confirm a diagnosis of exotropia.

The recommended treatment is eye muscle surgery to correct eye alignment if one or more of the following criteria are present:

• If the exotropia occurs more than 50% of the time each day.
• If the exotropia shows a gradual increase albeit not yet 50% of each day.
• If it is very noticeable when the child intently looks at nearby objects.
• If evidence suggests the child is losing binocular vision, which is the brain’s ability to use both eyes as a single unit.

If none of these criteria are met, then eye muscle surgery is not recommended. Instead, eyeglass or patching therapy can then be considered.

It is possible, with exotropia, that your child will have decreased vision in one eye. This is known as amblyopia, and the ophthalmologist will prescribe an eye patch to be worn over the stronger eye to strengthen the other through forced use.

Should your child need eyeglasses, these will be prescribed as well.

Surgery will not be recommended until optimal vision is achieved in each eye, with either patching or eyeglasses. But in some children, these measures are enough to improve the condition, making an operation unnecessary.

There is a small chance the exotropia could diminish with time if it is mild and none of the treatment criteria above are met. But if it is severe, and meets with any one of the criteria, it is unlikely the exotropia will improve without surgery.