exotropia

Burian (23) suggested that refraction is the key factor keeping convergence and divergence mechanisms in balance, whereas von Noorden (20) emphasized that patients with convergence insufficiency may not have exodeviation. Our findings of low myopia rate (7%) despite esotropia in 13 and exotropia in 14 of the strabismic patients supports the study by von Noorden (20) and underline the complex relationship between anisometropia and strabismus.

A possible explanation of this myopic shift during the control of the deviation at near is the stimulation of accommodation elicited by fusional convergence excessively stressed in the effort of overlap with the exodeviation [6, 8].

[5-8] It is advised by most authors that up to two-muscle surgery should be performed in one stage and if there is any exodeviation remaining, it should be corrected by a second stage surgery.

It was defined as a manifested or latent ocular deviation at a distance or near fixation with or without spectacle correction, which included an esodeviation of [greater than or equal to]10 prism diopters (PD), an exodeviation of [greater than or equal to]15 PD, or any vertical deviations.

In patients demonstrating convergence-induced nystagmus dampening, artificial divergence surgery can be used to induce an exodeviation, which can be overcome by employing fusional convergence; this is achieved through bimedial rectus recessions, which can be titrated to the degree of fusional reserves available.

Preoperative horizontal deviation was between 15 and 25 PD exodeviation in 4 patients and 20 PD esodeviation in one patient.

A 5-year-old male child presented with an exodeviation of the affected eye which was of recent onset.

A successful outcome was defined as esodeviation or exodeviation of 10 PD or less in primary position.