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Exotropia (Outward Eye Deviation)

Outward misalignment of the eyes manifesting as intermittent or constant divergence with potential impact on binocular vision.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Exotropia (Outward Eye Deviation)?

Exotropia represents approximately 25% of childhood strabismus and is classified by age of onset (congenital, infantile, childhood, adult) and pattern (intermittent, constant, sensory, consecutive). Intermittent exotropia is the most common form, presenting between ages 2-4 with manifest deviation triggered by fatigue, illness, daydreaming or distance fixation while maintaining good fusion at near.

Convergence insufficiency type intermittent exotropia presents with greater deviation at near than distance and responds well to orthoptic therapy and base-in prisms. Divergence excess type shows greater deviation at distance and may require surgical correction. Basic exotropia has equal deviation at distance and near.

Sensory exotropia results from chronic monocular vision loss (cataract, optic atrophy, severe amblyopia) and tends to occur in older children and adults. Consecutive exotropia may develop after esotropia surgery as overcorrection. Treatment depends on age, type, control of the deviation and amblyopia status, with goals of preserving binocular function and cosmesis.

Symptoms

Outward turning of one or both eyes
Intermittent or constant deviation
Squinting or closing one eye in bright sunlight
Eye strain and fatigue with prolonged tasks
Diplopia (double vision) — older children/adults
Reduced depth perception (stereopsis)
Reading difficulty and avoidance
Reduced control with fatigue or illness

Risk Factors

Family history of strabismus or amblyopia
Premature birth
Cerebral palsy and developmental delay
High myopia
Monocular vision loss (sensory exotropia)
Cranial nerve palsies
Genetic syndromes and craniofacial abnormalities
Prior strabismus surgery (consecutive type)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visible outward eye deviation at any age
  • Increasing frequency of intermittent deviation
  • Squinting or closing one eye in sunlight
  • Decreased control of deviation
  • Diplopia or new-onset exotropia in adulthood
  • Failed school vision screening
  • Family history with abnormal eye exam
  • Suspected sensory cause (asymmetric vision)

Treatment Methods

01
Comprehensive eye exam with cycloplegic refraction
02
Glasses for any significant refractive error
03
Part-time patching of dominant eye for control
04
Orthoptic exercises (pencil push-ups, brock string)
05
Base-in prisms for convergence insufficiency type
06
Bilateral lateral rectus recession surgery
07
Lateral rectus recession with medial rectus resection
08
Long-term follow-up to detect recurrence

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.