Exotropia is a manifest outward deviation of the visual axes,
which is either constantly or intermittently present. Untreated,
poorly controlled intermittent exotropia later progresses to
constant exotropia.
Sensory exotropia is unilateral divergent misalignment of the
eyes, resulting from loss of vision or long-standing poor vision
in an eye.
In sensory exotropia the angles are characteristically large,
ranging from 30 to 100 prism dioptres (PD) and increases
gradually over time as long as the cause of visual deficit remains
active. Treatment is directed to re-establish the normal ocular
alignment and binocular vision[1]. The preferred treatment
for manifest exotropia is surgery[2]. Large angle constant
exotropia negatively impacts the way the patients see
themselves and are perceived by others. The benefits of surgical
treatment of exotropia in adults is well proven, both
psychologically and visually. The surgical treatment for largeangle exotropia has been a subject of sufficient debate. A
variety of surgical plans have been described including two,
three or four horizontal rectus muscles recession and
resections with or without adjustable suture technique.[3] In
more recent studies, the management of large-angle exotropia
falls into two surgical approaches.
Large bilateral lateral rectus recession is done when the acuity
is good in each eye and indicated for true divergent excess
type. For basic exodeviation R-R procedure is done popularly.
Before embarking on surgical plan we do post occlusion test
and identify the clinical type.
If one eye is amblyopic, a maximal or supramaximal unilateral
recess- resect procedure is performed.
Records of previous studies have shown that monocular
surgery had shown good results for exotropia of < 60 PD. But
for exotropia of > 60 PD, monocular surgery was not so effective
(4).
In previous studies mild to moderate LR recessions were
described but our study involves maximum recession on LR.
In previous studies large LR recessions were reported to have
complications like Lid changes and palpebral aperture
widening.
This study was done to evaluate the outcome of single stage,
unilateral large LR recession with or without MR resection for
constant exotropia
Changes in Exodeviation after the Monocular Occlusion Test in Adult Patients with Intermittent Exotropia and Its Association with the Level of Control
