A Tale of Intermittent Exotropia and Amblyopia – Does Vision Therapy Help?

Among the types of exotropia in childhood, intermittent exotropia (IXT) has been reported to be the most common type. In a population-based cohort, the prevalence of exotropia has been reported to be 1%, with convergence insufficiency and intermittent exotropia being the commonest of the subtypes. A recent large population-based cohort of 5831 preschool children reports a prevalence of 3.2% of intermittent exotropia, with the basic and divergence excess being the most common of the subtypes. In a long-term follow-up of 184 paediatric patients over 9 years, 3.6% of children resolved; and over a 20-year period, 52.8% of the subjects had an increase in the angle of deviation by more than 10 prism diopters. In the management of IXT, surgery plays an important role in subjects who tend to increase in their angle of deviation and have associated visual and quality of life issues. The role of conservative management options like vision therapy still remains equivocal and no substantial evidence is available for the same. This case report emphasizes the role of vision therapy in the management of intermittent exotropia. Ms. H.V. a 6-year-old female with a diagnosis of intermittent exotropia and amblyopia was successfully managed with vision therapy. The child improved in aspects of both visual acuity and visual efficiency.