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Skilled pediatric ophthalmology and adult strabismus experts at UT Southwestern Medical Center have years of expertise in treating people with exotropia – eyes that turn outward.  Our doctors offer advanced care, such as surgery and prescribing proper glasses, to correct vision and realign the eyes.

Expert Eye Care for Exotropia

Exotropia is a type of strabismus (misaligned eyes) in which one or both of the eyes turn outward. The condition can begin as early as the first few months of life or any time during childhood.

Exotropia often begins as an intermittent problem, noticed only when the child is tired, sick, just waking up, excited, or stressed. Or it might not be noticeable to parents but detected during a routine eye exam.

Types of Exotropia

This eye condition can be congenital (present at birth) or acquired (developed in childhood). Acquired exotropia has three types:

  • Intermittent exotropia, which occurs occasionally
  • Sensory exotropia, which occurs in an eye with poor vision and causes it to turn outward
  • Consecutive exotropia, which can develop after surgery to treat crossed eyes

Causes of Exotropia

Exotropia, especially the intermittent type, often has no known cause. The condition might be associated with:

  • Very poor vision in one eye
  • Third cranial nerve palsy, which can paralyze or weaken eye muscles

Risk factors for exotropia include:

  • Family history of amblyopia (“lazy eye”), childhood cataract, glaucoma, or any type of strabismus
  • Certain genetic disorders that affect the eye 

Symptoms of Exotropia

Parents might notice one eye or both eyes occasionally turning outward, which is the most noticeable sign. Symptoms include:

  • Vision problems
  • Difficulty with depth perception
  • Sensitivity to bright light, resulting in squinting or closing one eye

Diagnosing Exotropia

UT Southwestern ophthalmologists perform a comprehensive medical eye exam to confirm a diagnosis of exotropia and rule out other conditions. We begin the evaluation by discussing the patient’s personal and family medical history. Our doctors will also recommend one or more of the following tests:

  • Vision test
  • Motor sensory exam, including ocular alignment test and extraocular muscle movement evaluation
  • Cycloplegic refraction tests, with dilating eyedrops, to check refraction without the eye being able to autofocus
  • Slit-lamp exam to look at structures inside the eye
  • Fundus examination using a specialized microscope to see the details of the retina

Treatment for Exotropia

For people whose exotropia does not often occur, observation by an ophthalmologist might be the only treatment needed. For people who have more frequent exotropia, the goals for treatment include realigning the eyes, helping both eyes work together properly, and treating double vision and/or amblyopia, or “lazy eye” (if necessary). 

UT Southwestern eye specialists offer treatment options such as:

  • Glasses, sometimes with bifocal or prism lenses, as needed
  • Eye patch on the stronger eye to strengthen the vision of the weaker eye in people with amblyopia
  • Surgery to align the eye muscles

In children with congenital/infantile exotropia, surgery is almost always the recommended treatment. Glasses might be recommended to correct refractive error and help improve the alignment of the eyes.  

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