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Major Review:
Intermittent Exotropia
Basic and Divergence Excess Type

JEFFREY COOPER, M.S., O.D. and NORMAN MEDOW, M.D.

from the State College of Optometiy, the State University of New York, and the Department of Pediatric Ophthalmology, Manhattan Eye, Ear and Throat
1—Io.cnitai. New York. New York
I:
NOMENCLATURE &
INCIDENCE
A.
Nomenclature
B.
Incidence
C.
Progression
II:
SENSORY MOTOR FINDINGS
A. Motor findings
1.
AC/A ratio
2.
Results from occlusion
3.
+3.00 lens test
4.
Kushner classification
5.
Cover test findings
6.
Concomitancy
7.
Temporal characteristics
8.
Fusional amplitude
B.
Sensory findings
1.
Stereopsis &
physiological diplopia
2.
Suppression &
panoramic viewing
3.
Anomalous retinal
correspondence
4.
Lack of correspondence
III:
ETIOLOGY
A.
Anatomical/mechanical
B.
Active divergence
C.
AC/A ratio
D.
Phylogenic
E.
Hemiretinal suppression
F.
Genetic
G.
Chameleon Theory
IV:
TREATMENT
A. Orthoptics
1.
Active
2.
Occlusion
3.
Lens therapy
4.
Prism therapy
5.
Biofeedback
6.
Review & Summary of
Orthoptic Treatment

B.
Surgery
1.
History
2.
Intended initial
overcorrection
3.
Early vs late surgery
4.
Consecutive esotropia
5.
Bilateral lateral rectus
recession vs.
recession-resection
6.
Variance in surgical
results
7.
Surgery in older patients
8.
Review & Summary of
Surgical Treatment

C.
Recommended therapy
V:
CONCLUSION
Binocular Vision & Eye Muscle Surgery Qtrly°
Major Review: Intermittent Exotropia; Basic and Divergence Excess Type
J.
Cooper, MS. OD and N. Medow, MD
Summer of 1993 Volume 8 (No.3): 185-216
ABSTRACT: Intermittent exotropia is a unique strabismus with a specific set of sensory motor findings. This paper provides a comprehensive review of nomenclature, epidemiology, sensory motor findings, theories of etiology, and treatment of intermittent exotropia, of both basic and divergence excess types.
Acknowledgement:: We thank Norman Haffner, OD, PhD, President of the State College of Optometry for his support; Drs. Schlossman, Birnbau,n & carniglia for their review; and B. Kenul, H. Hankins, J. Downs & M. Samnulamy for their preparation of this ,nanuscript.

Correspondence and reprint requests: Dr. Cooper, State University of New York, State College of Optometry, 100 East 24th St., New York, NY 10010. Tel: (212) 780-5011; FAX: (718) 837-0431
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