February 13, 2011 by staff 

Exotropia, What is Exotropia? Exotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of strabismus. People with exotropia often experience crossed diplopia. Intermittent exotropia is a fairly common condition. “Sensory Exotropia” occurs in the presence of poor vision. Infantile exotropia (sometimes called “congenital exotropia”) is seen during the first year of life, and is less common than “essential exotropia” which usually occurs several years later.

The brain’s ability to see objects in three dimensions depends on the proper alignment of the eyes. When both eyes are properly aligned and aimed at the same target, the visual part of the brain fuses the forms into a single image. When one eye turns inward, outward, upward or downward, two different images are sent to the brain. This causes a loss of depth perception and binocular vision.

The causes of exotropia are not fully understood. There are six muscles that control eye movement, four that move up and down and two that move it side to side. All these muscles must be coordinated and working properly for the brain to see a single image. When one or more of these muscles do not work properly, some form of strabismus may occur. Strabismus is more common in children with disorders that affect the brain such as cerebral palsy, Down syndrome, hydrocephalus, and brain tumors. One study showed that children with exotropia are three times more likely to develop a psychiatric disorder compared to the general population.

The first sign of exotropia is usually a noticeable outward deviation of the eye. This sign may first be intermittent, occurring when a child is daydreaming, not feeling well, or fatigue. The gap may also be more visible when the child looks at something far away. Ladle or frequent rubbing of the eyes is also common with exotropia. The child will probably not mention seeing double, ie, double vision. However, it may close one eye to compensate for the problem.

Generally, exotropia progresses in frequency and duration. As the disease progresses, the eyes start to turn when you look at close objects as well as distance. If left untreated, the eye can be constantly, resulting in loss of binocular vision.

In young children to all forms of strabismus, the brain can learn to ignore the image of the misaligned eye and see that the image of the eye as light. This is called amblyopia, or lazy eye, and causes a loss of depth perception. In adults who develop strabismus, double vision sometimes occurs because the brain has been trained to receive images from both eyes and can not ignore the image of the eye turned.

A thorough eye examination including an ocular motility (Eye Movement) evaluation and assessment of internal ocular structures will allow an eye doctor accurately diagnose the exotropia. Although glasses and / or corrective therapy, exercises, or prisms may reduce or help control the outward turning eye in some children, surgery is often necessary.

It is a rare form of exotropia known as “convergence insufficiency” that responds well to treatment. This disorder is characterized by an inability of the eyes to work together when used for display nearby, such as reading. Instead of concentrating on the eyes as well as being close, it deviates outward.

Because of the risks of surgery, and because about 35% of people need at least another surgery, many people try vision therapy first. This visual exercise. Health insurance companies do generally not cover it.

Surgery is sometimes recommended if the exotropia is present for more than half of the day or if the frequency is increasing over time. Surgery is also indicated if a child has significant exotropia when reading or viewing objects near or if there is evidence that the eyes lose their ability to work as a single unit (binocular vision). If none of these criteria are met, surgery may be postponed pending simple observation with or without some form of glasses and / or correction processing. In mild cases, there is a chance that the exotropia decreased over time.

The surgical procedure for correction of exotropia involves making a small incision in the tissue covering the eye to reach the eye muscles. The muscles are then repositioned appropriate to allow the eye to move properly. The procedure is usually performed under general anesthesia. Recovery time is rapid, and most people are able to resume normal activities within days. After surgery, corrective eyeglasses may be needed and, in many cases, surgery is needed later to keep the eyes straight.

“William and Kate made the decision together. Sophie was very useful for Kate, her advisor on all the do’s and don’ts of royal life. It was a real ally.
“Sophie and Edward are both very happy to see how it pleased Lady Louise. It is truly the finest, most lovable little thing.

“Edward and Sophie have always been incredibly protective of her, but she is now in school.

“They know she will have to get used to being in the spotlight.
“And you could not deny him that chance. It is the ideal age to be a bridesmaid – not too old to be intimidated or embarrassed. It is so, so excited and they all look awfully sweet walking down the aisle. ”
It is possible to operate in an attempt to correct strabismus caused by exotropia, but it is understood that Edward and Sophie decided against the course of treatment, requiring general anesthesia with all the risks that entails.
[via wikipedia and online sources]

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