Elsevier

Ophthalmology

Volume 110, Issue 11, November 2003, Pages 2093-2096
Ophthalmology

Common forms of childhood exotropia

Presented in part at: American Association for Pediatric Ophthalmology and Strabismus 28th Annual Meeting, March, 2002; Seattle.
https://doi.org/10.1016/j.ophtha.2003.04.001Get rights and content

Abstract

Objective

To determine the most common forms of childhood exotropia.

Design

Retrospective, consecutive, observational case series.

Participants

All exotropic children (with ≥10 prism diopters) younger than 19 years from a predominantly rural Appalachian region evaluated from August 1, 1995 through July 31, 2001.

Methods

Demographic and clinical data were collected on all patients.

Main outcome measures

The relative proportion of the various forms of childhood exotropia.

Results

Two hundred thirty-five consecutive children without prior surgical treatment were evaluated for exotropia. Of the 235 study children, the specific forms of exotropia diagnosed and numbers were as follows: intermittent exotropia, 112 (47.7%); exotropia associated with congenital or acquired abnormalities of the central nervous system (CNS), 50 (21.3%); convergence insufficiency, 27 (11.5%); sensory exotropia, 24 (10.2%); paralytic exotropia, 5 (2.1%); congenital exotropia, 4 (1.7%); neonatal exotropia that resolved after 4 months of age, 3 (1.3%), whereas the remaining 10 (4.3%) had an undetermined form of exodeviation.

Conclusions

Intermittent exotropia was the most common form of divergent strabismus in this population. Exotropia associated with an abnormal CNS, convergence insufficiency, and sensory exotropia were also relatively common, whereas the congenital, paralytic, and late-resolving neonatal forms were uncommon.

Section snippets

Materials and methods

The medical records of all exotropic children younger than 19 years evaluated in the Division of Ophthalmology at East Tennessee State University College of Medicine, Johnson City, Tennessee from August 1, 1995 through July 31, 2001 were reviewed retrospectively. Approval from the institutional review board at East Tennessee State University was obtained. The geographic region of the study is predominantly rural, with no other pediatric ophthalmologists serving the population. In 1995, the

Results

Two hundred forty-nine consecutive children were evaluated for exotropia during the study period. Fourteen of the 249 patients were excluded for a history of strabismus surgery. The observed forms of exotropia among the remaining 235 study patients are shown in Table 1. Intermittent exotropia was the most common form of childhood exotropia, comprising 47.7% of the study patients. Ten (8.9%) of the 112 patients with intermittent exotropia displayed a constant deviation at their initial

Discussion

Intermittent exotropia was the most common form of childhood exotropia in this population, accounting for nearly half of the study patients. The only similar study on review found intermittent exotropia (comprised of both a deviation greater at distance than near and a deviation equal at distance and near) occurring in 81.3% of patients with exotropia,7 although the investigation was undertaken in a large urban center and the ages of the patients were not specified. Friedman and associates8

References (18)

There are more references available in the full text version of this article.

Cited by (0)

Manuscript no. 220861.

View full text