How to treat intermittent exotropia?

summary

Intermittent exotropia is a kind of strabismus between exotropia and concomitant exotropia. It refers to the fact that the optic axis is often separated and occurs at first when looking at the distance. When looking at the distance, the fusion divergence amplitude exceeds the fusion convergence amplitude, that is, exotropia occurs. Before intermittent exotropia occurs, there is exotropia. Let's share how to treat intermittent exotropia?.

How to treat intermittent exotropia?

First, in order to ensure the clear image of retina, the patients with obvious ametropia, especially astigmatism and anisometropia, should be corrected; Surgery with myopia should be corrected completely; For exotropia with hyperopia, correction of hyperopia will reduce the accommodative set and increase exotropia. Whether full correction or partial correction is needed depends entirely on the degree of hyperopia, patient's age and AC / a ratio. Infants usually less than + 2.00d can not be corrected. For larger patients, correction of hyperopia is usually necessary to avoid refractive fatigue. The elderly have exotropia with presbyopia, and their adjustment is weakened. If they have hyperopia, they need to be corrected, and the minimum degree can be given to help them look closer.

Second, the negative spherical lens can be used to correct intermittent exotropia as a temporary measure, or placed on the upper half of the bifocal lens to treat excessive separation; Or put it in the lower half of the bifocal lens to treat the insufficient convergence, stimulate the accommodative convergence and control the exotropia. This kind of treatment should not be advocated. Children treated with this method often cause visual fatigue.

Third: prism and cover therapy: bottom inward prism can strengthen the stimulation of bilateral fovea. About 1 / 2-1 / 3 deviation can be corrected by prism stimulation fusion. Recently, it was proposed that cover is a good non-surgical treatment in the early stage of intermittent exotropia. With this method, about 40% of patients can change their apparent deviation (looking far) into cryptotropia. Early intermittent exotropia, because most of the time for the exotropia, the frequency of oblique is not much, the deviation is not big, do not advocate surgical treatment.

matters needing attention

For patients with mild undercorrection, if the residual inclination is less than 15-18 △, it can be achieved by de suppression and fusion ensemble training. If the patient is myopic, it should be corrected completely. If it is emmetropia or hyperopia, cycloplegic agent can be used to stimulate the accommodative convergence, so that the eyes are in the right position. After using the above method to achieve fusion, the number of drops can be reduced, once every 3 days, and lasting for 2 months. At the same time, the use of base inward prism, whose power is consistent with that of undercorrection, is effective for patients with mature vision.