Management of Exotropia Flashcards
What is the characteristic of Convergence Insufficiency Exotropia?
Magnitude larger at near than distance; low AC/A
What defines Basic Exotropia?
Magnitude similar at distance and near; normal AC/A
Describe Divergence Excess Exotropia.
Magnitude larger at distance than near; high AC/A
What is Infantile Exotropia?
Relatively rare, large-angle constant congenital exotropia that occurs before 6 months of age and persists thereafter
It can be unilateral or bilateral.
What is Primary Infantile Exotropia?
Occurs sporadically, may be hereditary; no signs of systemic or ocular disease; often exceeds 30 Δ; relatively equal distance and near
What is Secondary Infantile Exotropia?
Associated with systemic or ocular disease
What is Sensory Exotropia?
Acquired, unilateral due to visual impairment; may occur at any age
Examples include congenital or traumatic cataract and retinal disease.
What are the prognostic factors affecting treatment and management of exotropia?
- Age of onset
- Duration
- Frequency
- Magnitude
- Sensory anomalies
- Prior surgery
How does age of onset affect prognosis in exotropia?
Early onset exo not as bad as early onset eso when intermittent
What is the treatment approach for exotropia with a magnitude of ≤ 25 PD?
Treated with vision therapy (VT)
What are the potential effects of Overminus Lens Therapy?
Improved IXT control scores but risk of myopia progression increased
Coffey et al. reported 28% effectiveness.
What are the prerequisites for Prism Therapy?
- Normal correspondence
- Normal sensory fusion
- Minimal suppression
What is the effectiveness of Occlusion Therapy according to Coffey et al.?
37% effectiveness
What is the goal of Surgical Intervention for large angles of exotropia?
Reduce magnitude of deviation and address motor aspect of exotropia
What is the recurrence rate of exotropia after surgical intervention?
- 5 years: 54%
- 10 years: 76%
- 15 years: 86%
What is the effectiveness of Botox for treating exotropia?
45% cosmetic cure, but less stable over time compared to surgery
What is the estimated treatment time for Constant XT?
4-6 months; more time needed if amblyopia, suppression, anomalous correspondence and/or eccentric fixation present
What is a recommended approach to refractive correction in preschoolers with exotropia?
Take caution if considering part-time or full-time overminus lens therapy; cut plus equally from both eyes
What are the goals of Active Vision Therapy?
Develop sensory fusion and motor control; requires patient maturity, time, travel, commitment and motivation
Fill in the blank: The characteristic of Basic Exotropia is that the magnitude is _______.
similar at distance and near
True or False: Sensory Exotropia can develop at any age.
True
