This protocol addresses exotropia presenting in an intermittent pattern — a form of outward ocular deviation in which alignment fluctuates rather than remaining constantly misaligned.
Childhood-onset exotropia is typically intermittent. It usually appears before 3 years of age, though it may be first detected later in childhood. The intermittent nature distinguishes this presentation from constant forms of exotropia.
The primary objective is improved control of the exotropia — reducing the frequency and extent of the outward deviation to support binocular alignment and visual function.
First-line management involves careful evaluation and correction of refractive status. Optical correction is central to this approach — the full protocol specifies the clinical criteria and prescribing considerations.
DOI: 10.1016/j.ophtha.2022.11.002
Childhood-onset exotropia is typically intermittent and usually appears before 3 years of age, but it may be first detected later in childhood.
In the setting of an exodeviation, corrective lenses should be prescribed for any clinically significant refractive error that causes reduced vision in one or both eyes.
If hyperopic correction is necessary, the amount prescribed is the least amount needed to promote good vision while still promoting accommodative convergence to control the exodeviation.
Improved retinal-image clarity often improves the control of the exotropia.
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