Journal article
Divergence excess and basic exotropia types of intermittent exotropia: a major review. Part 1: prevalence, classification, risk factors, natural history and clinical characteristics
Strabismus, v 31(2), pp 97-128
03 Apr 2023
PMID: 37489263
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IntroductionIntermittent exotropia (IXT) is a common form of strabismus. It is an outward deviation of one eye typically when viewing at distance. Symptoms include, but are not limited to double vision, eyes feeling tired, excessive blinking, and reduced quality of life. Its clinical characteristics are distinctive from other types of strabismus. This paper provides a comprehensive review of prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT.MethodsSearch strategies involving combination of keywords including intermittent exotropia, exotropia, divergences excess, basic exotropia, prevalence, incidence, classification, terminology, risk factor, natural history, observation, angle of deviation, control, control score, symptom, quality of life, suppression, anomalous retinal correspondence, AC/A, accommodative convergence/accommodation, accommodative convergence, convergence, accommodation, vergence, incomitance and vertical were used in Medline. All English articles from 1900/01/01 to 2020/09/01 were reviewed. The reference list of the identified article was also checked for additional relevant article. Studies focused on animal model or strabismus associated with neurologic disorder or injury were excluded.ResultsThe estimated prevalence of IXT in children ranges from 0.1% to 3.7%. Hypoxia at birth and being female are potential risk factors of IXT. Using validated measures of control, multicenter prospective studies showed that the rate of conversion from IXT to constant exotropia is low. The angle of deviation is the most reported outcome measure in studies of IXT. It is often used to represent the severity of the condition and has been suggested as one of the four core outcomes for studies of the surgical management of IXT. Control of exodeviation is one of the four suggested core outcomes for study of surgery of IXT and is considered the main parameter of disease severity. Several validated tools for quality of life score are available to evaluate the subjective severity of IXT.DiscussionWe reviewed the prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT. Further research into these areas, especially its clinical characteristics (e.g. suppression, dual retinal correspondence), will increase our understanding of this condition and potentially lead to better management of this common form of strabismus.
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Details
- Title
- Divergence excess and basic exotropia types of intermittent exotropia: a major review. Part 1: prevalence, classification, risk factors, natural history and clinical characteristics
- Creators
- Martin Ming-Leung Ma - Sun Yat-sen UniversityMitchell Scheiman - Salus University
- Publication Details
- Strabismus, v 31(2), pp 97-128
- Publisher
- Taylor & Francis
- Number of pages
- 32
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:001032860000001
- Scopus ID
- 2-s2.0-85165632373
- Other Identifier
- 991021901714204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Ophthalmology