What is Exotropia
Exotropia, a form of Strabismus, is the outward deviation (turn) of an eye and occurs in 1.2% of children by 7 years of age and occurs equally in males and females. In exotropia, one or both eyes turn out.
What are the symptoms
The person's eye or eyes appear to be turned out. Many children with exotropia shut one eye in outdoor light.
The deviation may occur while fixating (looking at) distance objects, near objects or both. Fortunately, most exotropia is intermittent - the eye deviation or turn occurs only some of the time. Intermittent exotropia is the most common divergent strabismus in childhood.
When the turn occurs during distance viewing the major problem is cosmetic. The child might be accused of daydreaming or not paying attention. The parents will often notice the turn then bring their child to the eye doctor who won't find it. This is because the turn usually occurs during times of inattention, fatigue, or distance viewing not during the anxiety-provoking eye examination. These children often close their eye in bright sunlight.
When the turn occurs primarily at near (convergence insufficiency) the principal symptoms include diplopia, headaches, loss of concentration while reading, carsickness, avoidance of reading, blurred vision, and/or eyestrain. This is the most common type of muscle problem occurring in approximately 5% of the population. Symptoms are on the rise with increase reading and computer use.
What causes Exotropia
The cause of exotropia is not known. Most experts believe that the brain has trouble controlling the position of they eye. This problem may run in families.
The age of onset varies but is often between 6 months and 4 years. As long as the eyes are straight some of the time, the brain will develop some normal functioning of the eyes (stereoscopic depth perception). Since the brain and eyes work properly some of the time, time is on your side.
Sometimes when a child's eyes are not aligned on the same target, the brain ignores the image from one eye. That eye works less, and vision stops developing. This problem (called amblyopia) occurs rarely with exotropia. It is more common with other forms of strabismus.
Exotropia may result from:
- nerve problems
- eye injuries
- head injuries
How is Exotropia diagnosed
Parents, caregivers, or family members usually notice that the eyes are not pointed in the same direction. An ophthalmologist (medical eye doctor) will test the person's overall vision and ability to follow objects with each eye.
How can Exotropia be treated
Often an eye doctor will suggest surgery. However, treatment for intermittent exotropia does not have to occur immediately. As a matter of fact, early surgery has the potential of disturbing the ability of the brain for fusion in the future and can cause a permanent reduction in vision (amblyopia).
The following is a statement by two well known experts in the field of opthalmology M. R. Carlson and A. Jampolsky:
A hypothesis, previously proposed, of tight medial rectus muscles in conjunction with tight lateral rectus muscles associated with exodeviations as a cause of lateral incomitancy in intermittent exotropia is supported by clinical management. Three patients with these findings underwent bilateral medial rectus and lateral rectus recessions by means of the adjustable rectus recession technique. Primary position alignment was achieved, and rotations were balanced with the alleviation of the lateral incomitancy. The lateral rectus muscles were recessed an amount more than usual in order to compensate for the recession of the medial rectus muscles.
In other words: because some of the muscles controlling the movement of the eye are shorter on one side the eye moves to that side. Surgery consists of making incisions in these muscles to allow them to lengthen. The success rate of this surgery is only 48% and 35% and more have to return again to have a second and sometimes even third operation.
Published success rates are higher for vision therapy than surgery. Many surgeons do not advocate vision therapy either because they are surgeons and thus like to operate and/or they do not have the facilities to perform vision therapy, and/or have not read the medical literature on vision therapy and unaware of its proven success rates in the treatment of exotropia.
Prismatic glasses can be prescribed to decrease some of the symptoms. Though prisms are effective they are not as effective as vision therapy and may result in adaptation problems so that more prism is necessary in the future to alleviate symptoms. Every Optometric and Ophthalmological textbook agrees that the primary treatment of convergence insufficiency should be vision therapy.
Even if you have already had surgery it should be followed up with a Natural Vision Program like Eyerobics. Remember, surgery may lessen the work load but it does not reinforce the eyes working together. Many surgical patients have their strabismus come back in the future. Many surgical patients have multiple surgeries without lasting positive results.
How can Eyerobics help
The Eyerobics program is a program of eye exercises based on the Bates Method and they are designed to address most eye disorders by improving the function of your eye muscles and at the same time relaxing them. Because the focus is on improving your eye muscles this program is very well suited to address exotropia. The problem with exotropia is the different tensions of the eye muscles. If all muscles would be as strong and tight than it would be impossible for your eye to involuntarily move to one direction.
The Eyerobics exercises are designed to address ALL muscles making them all as strong and relaxed. To discover all the advantages of the program, our money-back guarantee and the price, read on....
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