Exotropia

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Exotropia
Synonyms	Divergent strabismus
Pronounce	N/A
Specialty	N/A
Symptoms	Outward deviation of one or both eyes
Complications	Amblyopia, diplopia
Onset	Can occur at any age
Duration	Can be intermittent or constant
Types	N/A
Causes	Genetic factors, neurological issues, muscle imbalance
Risks	Family history of strabismus, premature birth, cerebral palsy
Diagnosis	Cover test, Hirschberg test, prism cover test
Differential diagnosis	Esotropia, hypertropia, hypotropia
Prevention	N/A
Treatment	Vision therapy, corrective lenses, strabismus surgery
Medication	None specific, but botulinum toxin injections may be used
Prognosis	N/A
Frequency	Common
Deaths	Not directly life-threatening

Exotropia: A Detailed Overview

Exotropia refers to a specific form of strabismus, where one or both eyes turn outward, away from the nose. This eye misalignment can be present intermittently or constantly, and its manifestation can have multiple underlying causes.

Illustration showing an eye with exotropia.

Understanding the Basics

What is Strabismus?

Strabismus is a general term used to describe misaligned eyes. When an individual has strabismus, their eyes do not look at the same point simultaneously. Exotropia is one of the types of strabismus where the eye(s) deviate outward.

Types of Exotropia

Exotropia can manifest in various forms:

• Intermittent Exotropia: The most common form where the outward deviation occurs occasionally, often when the individual is daydreaming, feeling unwell, or tired.
• Congenital or Infantile Exotropia: Noticed in infants, it's less common than other types and requires early intervention.
• Sensory Exotropia: Occurs as a result of poor vision in one eye.
• Consecutive Exotropia: Arises after surgery for esotropia, which is an inward deviation of the eye.

Causes and Risk Factors

While the exact cause of exotropia often remains unknown, several risk factors may contribute:

• Family history of strabismus.
• Premature birth.
• Certain systemic or neurological conditions.
• Trauma to the eye or surrounding area.

Symptoms and Diagnosis

While the primary symptom is the visible outward turning of one or both eyes, others include:

• Blurred vision.
• Double vision.
• Difficulty with depth perception.
• Closing or covering one eye, especially in bright sunlight.

For a proper diagnosis, a comprehensive eye examination is conducted, often including:

• Visual acuity test.
• Refraction test.
• Alignment and focusing test.
• Examination of eye health.

Eye examination in progress.

Treatment Options

The treatment for exotropia varies based on its severity, frequency, and the underlying cause:

• Eyeglasses or Contact Lenses: For those with uncorrected refractive errors.
• Patching: Covering the dominant eye to strengthen and improve vision in the weaker eye.
• Eye Exercises: To improve control over the misaligned eye and enhance binocular vision.
• Surgery: Adjusting the length or position of eye muscles to achieve proper alignment.
• Botox Injections: Temporarily paralyzing the overactive eye muscle.

Living with Exotropia

Individuals with exotropia often face challenges beyond visual disturbances. This condition can lead to:

• Self-consciousness or embarrassment.
• Difficulty in social interactions due to perceived difference.
• Potential for bullying in children.

Early diagnosis and intervention can greatly improve both the functional and psychological outcomes for those with exotropia.

Conclusion

Exotropia, while primarily a physical condition, can have significant emotional and psychological ramifications. Understanding its nuances and ensuring timely interventions can greatly enhance the quality of life for those affected.

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