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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

  • 1Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA. phillipspaulh@uams.edu

The British Journal of Ophthalmology
|November 22, 2005
PubMed

Insights

Children with intermittent exotropia showing increased near deviation may have underlying neurological conditions. This finding highlights the importance of neurological assessment in such cases.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology

Context:

  • Intermittent exotropia is a common childhood eye misalignment.
  • The relationship between specific patterns of exotropia and neurological conditions requires further elucidation.

Purpose:

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

Summary:

  • A retrospective study compared children with intermittent exotropia exhibiting a near deviation exceeding distance deviation by ≥10 prism diopters (study group) to those with distance deviation ≥ near deviation (control group).
  • The study group showed a significantly higher prevalence of neurological abnormalities (66%) compared to the control group (19%).
  • Identified neurological conditions included developmental delay, attention deficit disorder, cerebral palsy, and others.

Impact:

  • Findings suggest that a specific pattern of intermittent exotropia, characterized by increasing near deviation, is a significant indicator of underlying neurological disease in children.
  • This association underscores the need for comprehensive neurological evaluation in pediatric patients presenting with this type of exotropia.
Abstract

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