J Korean Ophthalmol Soc.  2022 Nov;63(11):928-934. 10.3341/jkos.2022.63.11.928.

First-finder-related Clinical Features of Intermittent Exotropia

• Kim CW
• Kim SW
• Yu J
• Chung SA

• KMID: 2535894
• DOI: http://doi.org/10.3341/jkos.2022.63.11.928

Abstract

Purpose
To determine whether the clinical features of intermittent exotropia (IXT) needing muscle surgery were different in the ophthalmologist-detected and non-specialist-detected groups (including parents).
Methods
Medical records of 218 children (mean age: 5.9 ± 1.4 years) with IXT of ≥ 20 prism diopters (PD) were reviewed retrospectively. The angles of deviation were measured using the prism and alternate cover test and assessed by two ophthalmologists using photographs with a translucent occluder (photographic angle). The IXT subtype, fusional control, stereopsis, suppression, and spherical equivalent (SE) were compared between the ophthalmologist-detected and non-specialist-detected groups.
Results
Mean 25.8 ± 6.8 PD of distant angle of IXT was first detected by the ophthalmologist in 41 patients (18.8%) and the non-specialists in 177 patients (81.2%). The deviated eye was more myopic in the ophthalmologist-detected than non-specialist- detected group (-0.77 ± 1.59 diopters [D] vs. -0.19 ± 1.48 D, p = 0.03). There were no other differences between the two groups. A comparison of 39 age- and non-dominant eye SE-matched pairs demonstrated that the measured angles for distant and near fixation were smaller in the ophthalmologist-detected than non-specialist-detected group (24.0 ± 6.8 PD vs. 28.5 ± 6.4 PD and 26.9 ± 6.6 PD vs. 31.0 ± 6.4 PD, respectively, p < 0.01), while the remaining characteristics, including the photographic angle, were similar.
Conclusions
In cases with small angles of deviation or myopia, IXT with angles requiring surgical correction were commonly first detected by ophthalmologists during examinations.

Keyword

Angle of deviation; Detection; Intermittent exotropia; Ophthalmologist; Photographs using a translucent occluder