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Intermittent exotropia increasing with near fixation: a "soft" sign of neurological disease

P H Phillips1, K J Fray, M C Brodsky

  • 1Department of Ophthalmology, University of Arkansas for Medical Sciences, and Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA. phillipspaulh@uams.edu

The British Journal of Ophthalmology
|August 23, 2005
PubMed

Insights

Children with intermittent exotropia showing increased near deviation are significantly more likely to have neurological disease. This finding highlights a crucial link between eye alignment and brain health in pediatric patients.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Strabismus Research

Background:

  • Intermittent exotropia is a common childhood eye misalignment.
  • The relationship between the degree of deviation at distance versus near fixation and underlying neurological conditions requires further investigation.

Purpose of the Study:

  • To investigate the association between distance-near disparity in intermittent exotropia and the prevalence of neurological disease in children.

Main Methods:

  • Retrospective analysis of medical records of children with intermittent exotropia (1989-2002).
  • Study group: near deviation exceeded distance deviation by ≥10 prism diopters.
  • Control group: distance deviation ≥ near deviation.

Main Results:

  • The study group (n=29) showed a 66% prevalence of neurological abnormalities, compared to 19% in the control group (n=37).
  • Neurological conditions included developmental delay, attention deficit disorder, cerebral palsy, and seizures.
  • The difference in neurological disease prevalence was statistically significant (p=0.0002).

Conclusions:

  • Intermittent exotropia with increasing near deviation is significantly associated with neurological disease in children.
  • This association underscores the importance of evaluating for neurological conditions in children presenting with this specific pattern of exotropia.
Abstract

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