Table 5.
Authors (year) | Number of patients | Age of the patients | Treatment method | Follow-up | Mean results |
---|---|---|---|---|---|
Chung et al.35 | 114 | Optical correction alone | 6 months | In hyperopic cases a narrow increase in exodeviation following hyperopic correction was seen In myopic cases, the angle of deviation remained constant or decreased following wearing eyeglasses Optical correction in cases with exotropia is useful prior to strabismus surgery and considering a new angle of deviation after spectacle correction should result in better results |
|
Mohney et al.36 | 177 | 12-35 months | Part-time occlusion versus observation alone | 3 h daily for 5 months, followed by 1 month of no patching | Observation does not result in the deterioration of IXT in the age range 12-35 months Deterioration over 6 months was uncommon, with or without patching treatment |
Buck et al.19 | 460 | <12 years | Observation | 2 years follow up | There is a very low risk of deterioration within 2 years after a diagnosis of IXT |
Chen et al.37 | 58 | 3-6 years | Minus therapy versus observation alone | 8 weeks | Minus therapy has a better effect on IXT control than no intervention at all |
Cotter et al.38 | 358 | 3-10 years | Part-time occlusion versus observation alone | 3 h daily for 5 months, followed by 1 month of no patching | A low rate of deterioration was observed in both groups (6.1% in the observation group and 0.6% in the occlusion group) No significant difference between observation and patching |
Alkahmous and Al-Saleh39 | 21 | 4-10 years | 6 h a day alternate occlusion | 6 months | Alternate occlusion improved the sensory status and strengthened the fusional amplitudes at near and distance. Moreover, alternate patching could also improve IXT control but did not improve the angle of deviation |
Bayramlar et al.40 | 19 | 3-14 years | Over-minus lenses therapy | Median period of 18 months (6-33 months) | Overcorrecting minus therapy could decrease deviation and improve the patient’s status and should be considered as the first line of treatment |
Mangad et al.41 | 53 | 1-5 years | Over-minus lenses therapy | 1 year | Over-minus correction improves IXT control (lowers the NCS score) and decreases the angle of deviation at distance and near |
Samy et al.42 | 100 | 5-7 years | Inverse prism addition versus conventional prism addition | 12 months | The two types of prism therapy showed comparable improvements in NCS This study highlights the potential role of inverse prism therapy as a non-invasive method for enhancing basic IXT control |
Hardesty et al.43 | 100 | 2-24 years | Surgery alone versus surgery and orthoptic therapy | Six and one tenth years (1-10 years) | Improvement in 50% of the subjects who underwent both surgical intervention and orthoptic therapy while only 32% of the patients who only underwent surgery improved |
Asadi et al.44 | 74 | 4-54 years | Office and home-based training exercises | 8 weeks | Orthoptic treatment seems to be effective in reducing symptoms and improving signs of intermittent exotropia Combination of in-office and home-based therapy tends to produce better results than does home-based therapy alone |
Peddle et al.45 | 2 | 30 and 32 years | Binocular vision therapy/orthoptics | 30 weeks | Vision therapy was highly successful in patients with childhood intermittent exotropia of the basic type Vision therapy can eliminate the patients’ symptoms of asthenopia and diplopia without the need for surgery Using vision therapy exotropia at distance and near was reduced, patients achieved required fusion at all distances, and their symptoms improved |
Spencer et al.46 | 32 | 3-12 years | Bilateral injections of 2.5 units botulinum toxin injection to the lateral rectus muscles | 12-44 months | Botulinum toxin is at least as effective as surgical outcomes reported previously for the treatment of intermittent exotropia in children This treatment method is particularly effective in children between 2 and 4.5 years of age irrespective of the initial strabismic angle and is not associated with any secondary abnormalities |
Etezad Razavi et al.47 | 21 | 5-18 years | Botulinum toxin injection to the lateral rectus muscles | 6 months | Botulinum toxin injection to lateral rectus muscles seems to be a promising procedure in the management of fusional control, far and near deviations in patients with intermittent exotropia in short time |
IXT: Intermittent exotropia, NCS: Newcastle Control Score