Conservative management of intermittent distance exotropia: a review

Piano, M and O’Connor, AR (2011) Conservative management of intermittent distance exotropia: a review American Orthoptic Journal, 61 (1). pp. 103-116.

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Abstract

Background and Purpose: Intermittent distance exotropia is difficult to conservatively manage, with techniques varying widely between institutions. This review aims to examine current literature on conservative management for intermittent distance exotropia, investigate its impact upon current clinical practice, and identify areas for further research. Method: A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1950 and the present day were considered. Results: Intermittent distance exotropia is a difficult condition to manage because of its variability / uncertain natural history, although control scores can facilitate management decisions. Research is required to establish recommended dosages for antisuppression occlusion and determine whether other treatments such as minus lenses are more effective. Use of orthoptic exercises has declined, but recently certain exercises have been shown to improve surgical outcomes if applied preoperatively. Prisms are mainly used postoperatively. Minus lens therapy is recommended as a first line treatment, but may not always be successful. Conclusion: Conservative management techniques for intermittent distance exotropia have their place as both an alternative and an adjunct to surgery. However, further research needs to be conducted to determine which techniques are appropriate for which patients.

Item Type:	Article
Subjects :	Medical Science
Divisions :	Faculty of Health and Medical Sciences > School of Health Sciences
Authors :	Name Email ORCID Piano, M O’Connor, AR
Date :	1 January 2011
DOI :	10.3368/aoj.61.1.103
Copyright Disclaimer :	© 2011 Board of Regents of the University of Wisconsin System
Uncontrolled Keywords :	Intermittent distance exotropia, Conservative management, Minus lens therapy, Control score, Antisuppression, Orthoptic exercises, Prisms
Depositing User :	Symplectic Elements
Date Deposited :	04 Aug 2016 15:20
Last Modified :	31 Oct 2017 18:33
URI:	http://epubs.surrey.ac.uk/id/eprint/811608

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