Intermittent Exotropia and Accommodative Esotropia: Distinct Disorders or Two Ends of a Spectrum?

In clinical diagnosis, we often imbue medical disorders with distinct personalities based on a constellation of findings with little understanding of their underlying causes. Our purpose here is to juxtapose intermittent exotropia and accommodative esotropia and to consider the possibility that they represent a continuum of horizontal deviation, rather than distinct mechanisms of disease. Over years of observation, we have come to view intermittent exotropia and accommodative esotropia as diametrical disorders of horizontal eye position that use common binocular control mechanisms. Intermittent exotropia is characterized by a gradual, progressive exodeviation of either eye that is present mainly during distance fixation or