title: Changes in exodeviation following hyperopic correction in patients with intermittent exotropia.
abstract: OBJECTIVE
  To evaluate changes in the angle of deviation after spectacle correction in patients who had hyperopia and intermittent exotropia (X(T)) and to determine whether the changes and surgical outcomes differ when compared with those of myopic and emmetropic X(T).
  
  
  METHODS
  One hundred fourteen patients with X(T) were recruited and allocated into three groups: X(T) with hyperopia (group I; 38 patients), X(T) with emmetropia (group II; 35 patients), and X(T) with myopia (group III; 41 patients). After at least 6 months wearing spectacles, changes in exodeviation were compared. The results of surgery based on the spectacle-corrected distance angle and the ratios of accommodative convergence over accommodation (AC/A) were also assessed.
  
  
  RESULTS
  With spectacle correction, the mean exodeviation increased significantly in group I, but did not change in groups II or III. Thirteen patients in group I (34%) showed a more than 10 prism diopters (PD) exotropic shift after wearing spectacles. The mean AC/A ratio in group I was 2.63 (PD/D), whereas in groups II and III the ratios were 4.03 and 4.06, respectively. There was no difference in surgical results among the three groups.
  
  
  CONCLUSIONS
  Although hyperopic correction in patients with X(T) resulted in a limited increase in exodeviation with a subnormal AC/A ratio, one-third of the patients experienced a significant increase in exodeviation. A spectacle correction trial should be considered before surgery in patients with hyperopia and X(T).
authors.affiliation: Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seung Ah
authors.initials: SA
authors.lastname: Chung
authors.forename: In Sik
authors.initials: IS
authors.lastname: Kim
authors.forename: Wook Kyum
authors.initials: WK
authors.lastname: Kim
authors.forename: Jong Bok
authors.initials: JB
authors.lastname: Lee
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003290:Convergence, Ocular / Q000502:physiology*; D058453:Emmetropia / Q000502:physiology; D005099:Exotropia / Q000503:physiopathology / Q000628:therapy*; D005139:Eyeglasses; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000628:therapy*; D007223:Infant; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000628:therapy; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D015348:Vision, Binocular / Q000502:physiology*; D055815:Young Adult