Exotropia

Exotropia

  • Overview
  • Appointments
  • Symptoms
  • Diagnosis
  • Treatments
  • Locations
  • Doctors
  • Providers

    • What is exotropia?

    Exotropia—or an outward turning of the eyes—is a common type of strabismus accounting for up to 25 percent of all ocular misalignment in early childhood. Transient intermittent exotropia is sometimes seen in the first 4 - 6 weeks of life and, if mild, can resolve spontaneously by 6 - 8 weeks of age. Constant exotropia is only rarely present at birth (congenital). More commonly, exotropia develops between 1 - 4 years of age, first seen only intermittently, particularly when the child is daydreaming, ill, tired, or when a child is focusing on distant objects. It will often disappear when the child is focusing on close objects, as when talking to you, making discovery difficult. 

    Bright light can also induce wandering and parents often report that the child squints or closes one eye in bright sunlight. The frequency and size of the deviation can increase with time making it more noticeable. Your child will often not report double vision or other symptoms when the eye deviates because the developing visual system has the ability to turn off the wandering eye. This, however, can inhibit the eyes connection to the brain resulting in amblyopia (poor vision in one eye from disuse) or loss of depth perception. If untreated, these changes can become permanent.

    What causes exotropia?

    Exotropia may be seen in children with very poor vision in one eye (sensory exotropia) or in association with certain genetic disorders that affect the eyes. It may also occur in association with a 3rd cranial nerve palsy or previous eye muscle surgery for strabismus. But, most often, childhood intermittent exotropia has no known cause so, if outward wandering of the eyes is suspected and persistent, your child should be evaluated by an ophthalmologist or orthoptist.

    What are the risk factors for exotropia?

    The risk factors are: 

    • Positive family history of strabismus (misaligned eyes), amblyopia, childhood cataract, or glaucoma
    • Some genetic disorders that affect the eyes
    • Pediatric cataracts or glaucoma
    • But most often there are no known risk factors in children with exotropia

    Appointment Information

    To schedule an appointment or for any questions, please call 734-764-7558.

    What are the symptoms of exotropia?

    The symptoms are:

    • Decreased vision
    • Decreased depth perception
    • Outward deviation of the eyes, often intermittently at first
    • Sensitivity (closing one eye) in bright light

    The symptoms described above may not necessarily mean that your child has exotropia. However, if you observe one or more of these symptoms, see an ophthalmologist for a complete exam.

    How is exotropia diagnosed?
    • Visual acuity measurement in each eye and both eyes together (age appropriate)
    • Cycloplegic refraction (with dilating eye drops)
    • External or slit lamp exam
    • Fundus (retina) examination
    • Complete eye exam (age appropriate)

    How is exotropia treated?

    In some children, where the exotropia is infrequent or “well-controlled,” close observation by an orthoptist or ophthalmologist, without other specific treatment, is warranted. When the exotropia appears more frequently and is “poorly-controlled,” other treatment may be necessary. Although glasses, exercises, or prisms are sometimes prescribed to reduce or help control the outward turning eye in some children, surgery is often needed to properly re-align the eyes while still young enough to allow development of stereopsis (3-dimensional vision) and prevent permanent vision loss from amblyopia. 

    Surgery, if indicated, involves weakening the lateral rectus muscle on one or both eyes or sometimes strengthening the medial rectus instead or both. It is usually performed by your ophthalmologist as an outpatient with minimal pain and a rapid recovery allowing children to return to school or day care in just 2 - 3 days.

    Locations
    • Ophthalmology Clinic | Brighton Center for Specialty Care 7500 Challis Rd
      Entrance 1, Level 2
      Brighton, MI 48116-9416       Get Directions
    • Ophthalmology Clinic | Canton Health Center 1051 N Canton Center Rd
      Canton, MI 48187-5097       Get Directions
    • Ophthalmology Clinic | Northville Health Center 39901 Traditions Dr
      Floor 2
      Northville, MI 48168-9493       Get Directions
    • Ophthalmology Clinic | River Place Office Building 1974 N Huron River Dr
      River Place Offices
      Ypsilanti, MI 48197-1654       Get Directions
    • Pediatric Ophthalmology & Adult Strabismus Clinic | Kellogg Eye Center 1000 Wall St
      Floor 1
      Ann Arbor, MI 48105-1912       Get Directions
    • Pediatric Ophthalmology Clinic | Trinity Health Oakland Hospital Medical Office Building
      44555 Woodward Avenue, Suite 405
      Pontiac, MI 48341       Get Directions

    Doctors

     Search for a U-M Health doctor

    Steven M Archer, MD

    Professor

    Ophthalmology

    Monte Del Monte, MD

    Monte Anthony Del Monte, MD

    Professor Emeritus

    Ophthalmology

    Christopher Gappy, MD

    Clinical Assistant Professor

    Ophthalmology

    Michigan Photo

    Adam Brent Jacobson, MD

    Clinical Assistant Professor

    Ophthalmology

    Otana Agape Jakpor, MD

    Otana Agape Jakpor, MD

    Clinical Assistant Professor

    Ophthalmology

    Dolly Padovani-Claudio, MD, PhD

    Dolly Ann Padovani Claudio, MD

    Clinical Instructor

    Ophthalmology

    Lev Prasov, MD

    Lev Prasov, MD, PhD

    Assistant Professor

    Ophthalmology

    Breanna Marie Tracey, MD

    Breanna Marie Tracey, MD

    Clinical Instructor

    Ophthalmology

    Grace Meng Wang, MD

    Grace Meng Wang, MD, PhD

    Clinical Assistant Professor

    Ophthalmology

    Marguerite Cullen Weinert, MD

    Marguerite Cullen Weinert, MD

    Clinical Assistant Professor

    Ophthalmology

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    Providers

     Search for a U-M Health provider     Courtney Amanda Dewey, OD

    Courtney Amanda Dewey, OD

    Clinical Assistant Professor

    Optometry

    Carlton J Foster, OD

    Carlton J Foster, OD

    Clinical Instructor

    Optometry

    Jacqueline Nguyen, OD

    Jacqueline Dinh Hoan My Nguyen, OD

    Clinical Assistant Professor

    Optometry

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