Exotropia in children with high hyperopia.
OBJECTIVE
To describe the clinical characteristics, treatment, and subsequent clinical course of children with exotropia and high hyperopia.


METHODS
The medical records of 26 patients seen between 1990 and 2009 who had an exotropia and ≥4.00 D of hyperopia were retrospectively reviewed. We analyzed the clinical characteristics, treatments, and subsequent alignment outcomes.


RESULTS
A total of 26 patients between the ages of 2.5 months and 9 years were included. Of these, 15 had associated medical conditions or developmental delay. Of 22 patients with measured visual acuities, 19 had amblyopia (10 unilateral, 9 bilateral). None of the patients demonstrated fine stereoacuity. Twenty-three exotropic children were treated with spectacles: 15 were fully corrected, 10 of whose exotropia improved; 8 received partial correction of their hyperopia, 3 of whose exotropia improved. Six patients who presented with large, poorly controlled exotropia and did not improve with spectacle correction required strabismus surgery.


CONCLUSIONS
Children with high hyperopia and exotropia are likely to have developmental delay or other systemic diseases, amblyopia, and poor stereopsis. Treatment of high hyperopia in exotropic children with their full cycloplegic refraction can result in excellent alignment.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
Iris S
IS
Kassem
Steven E
SE
Rubin
Sylvia R
SR
Kodsi
D000550:Amblyopia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications; D005099:Exotropia / Q000150:complications* / Q000628:therapy; D005139:Eyeglasses; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000150:complications* / Q000628:therapy; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology