Exotropia

Key Features

• Type of strabismus in which the eyes are divergent/wall-eyed

• May be intermittent or constant and involve one or both eyes

Clinical Findings

• Deviation of the eyes toward the ears most often begins intermittently and occurs after age 2 years

• Congenital exotropia is extremely rare in an otherwise healthy infant

• Early-onset exotropia may occur in infants and children with severe neurologic problems

Diagnosis

• Evaluation of the corneal light reflex reveals the penlight's reflection in the deviated eye is displaced nasally

• All children with constant, congenital exotropia require CNS neuroimaging

Treatment

• Surgery

• Orthoptic exercises

• Patching

• Glasses (occasionally)

• Referral to an ophthalmologist is indicated