PubMed · 3253213
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R Garg, V Menon, P Prakash. Proprioceptive reflexes in exodeviations.. https://pubmed.ncbi.nlm.nih.gov/3253213/
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Monocular eye closure in bright illumination is a common occurrence in intermittent exotropia. In a series of patients with intermittent exotropia with normal retinal correspondence and stereopsis while the eyes were in the straight position, monocular eye closure occurred in 90% of patients with normal retinal correspondence while exotropic and in only 35% of patients with abnormal retinal correspondence while exotropic. Monocular eye closure occurs in people with intermittent exotropia to avoid diplopia and visual confusion even though these are not usual complaints. The cortical adaptation of anomalous retinal correspondence prevents diplopia and visual confusion and obviates the need to close one eye in bright sunlight.
Constant exotropia is uncommon during the first year of life. We retrospectively identified 13 patients with large, constant exotropia during the first year of life which required surgery. Bilateral lateral rectus muscle recessions were done in all 13 cases. Only two patients have required reoperation. The clinical characteristics and management of this unusual condition are similar to those of infantile esotropia.
This paper presents a summary of information regarding divergence excess exotropia. The first portion of the paper deals with the description (i.e., definition, onset, natural history, prevalence, sexual distribution, symptomatology, and the differential diagnosis of the two subtypes) of this entity. The second portion of the paper reviews the various treatment options (surgery, lens therapy, prism therapy, and vision training) currently available with emphasis on vision training/orthoptics. We conclude that divergence excess exotropia is effectively managed at least as well by vision training/orthoptics as it is by surgery. We propose that future research examine in greater detail the characteristics of the subtypes of this entity to potentially derive improved training techniques for this population.