Clinical Analysis of Congenital Exotropia

ABSTRACT

Constant exotropia is uncommon during the first year of life.We investigated characteristics, surgical outcome and associated ocular abnormalities in patients who had an exodeviation during the first year of life. The charts of 18 patients who were diagnosed as congenital exotropia before 1 year old were reviewed.We etrospectively analyzed 10 healthy patients who did not have associated systemic or ocular abnormalities and were followed for at least 3 months after surgery. The mean follow-up period was 1.2 years[range, 3 months to 3.5 years]and all of them had an exodeviation of 25 prism diopter[PD]or more[mean, 37.5PD, SD 10.6PD].Preoperative DVD and inferior oblique muscle overaction were found in 1 patient respectively. Surgery was performed in 9 cases and botulinum toxin was injected in 1 case.Seven patients[70%]showed stable alignment within 10PD with one operation and one patient required reoperation.Postoperative dissociated vertical deviation and inferior oblique muscle overaction were found in each 1 patients. Congenital exotropia has large deviation and may be associated with inferior oblique muscle overaction or dissociated vertical deviation as infantile esotropia and has stable alignment with single operation.But unlike infan-tile esotropia, nystagmus is extremely rare.