Related Experiment Video
Updated: Jul 19, 2026
Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
The use of the Newcastle Control Score in the management of intermittent exotropia
Deborah Buck1, Sarah R Hatt, Helen Haggerty
1Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Insights
The Newcastle Control Score (NCS) effectively measures intermittent exotropia (X(T)) severity in children. A high NCS score predicts the need for surgery, aiding clinical management.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Management
Background:
- Intermittent exotropia (X(T)) is a common childhood strabismus.
- Accurate assessment of X(T) severity is crucial for effective management.
- The Newcastle Control Score (NCS) is a potential tool for evaluating X(T).
Purpose of the Study:
- To evaluate the utility of the Newcastle Control Score (NCS) in managing intermittent exotropia (X(T)) in children.
- To assess the correlation between NCS scores and other measures of X(T) severity.
- To determine if NCS can predict the need for surgical intervention.
Main Methods:
- Children under 11 with X(T) underwent routine assessment including NCS.
- Data collected included visual acuity, near/distance alignment (prism cover test), and stereoacuity (Frisby, FD2TM).
- Statistical analysis involved correlations, longitudinal change assessment, and logistic regression for surgical predictors.
Main Results:
- Baseline NCS correlated significantly with near stereoacuity, near alignment, and distance alignment.
- A high NCS score (≥4) at follow-up was a strong predictor of requiring surgery (OR 29.3).
- The NCS demonstrated utility in assessing both baseline severity and changes over time.
Conclusions:
- The Newcastle Control Score (NCS) is a valuable measure for assessing the clinical severity of intermittent exotropia (X(T)).
- The NCS facilitates serial assessment of X(T) progression or improvement.
- The NCS is a practical tool for the clinical management of pediatric patients with X(T).
Aim:
To evaluate the use of the Newcastle Control Score (NCS) in the management of intermittent exotropia (X(T)).
Participants And Methods:
Children aged <11 years with X(T) had an assessment of NCS as part of routine management. Other data collected included visual acuity, near and distance alignment with alternating prism cover test and near (Frisby test) and distance stereoacuity (Frisby Davis Distance Stereotest (FD2TM)). Analysis involved correlation between baseline NCS, angle and stereoacuity, examination of change over time and logistic regression to determine predictors of surgery.
Results:
Baseline data were obtained on 272 children and follow-up data on 157. Mean (SD) age was 4 (1.9) years. Complete NCSs were obtained for all except one child at baseline, and all children at follow-up. At baseline, total NCS and the home control component were correlated with near stereo (r = -0.22, p<0.01 and r = -0.19, p<0.02, respectively), near alignment (r = 0.34, p<0.001 and r = 0.19, p<0.02) and distance alignment (r = 0.30, p<0.001 and r = 0.26, p<0.001). The clinic near control component was correlated with near alignment (r = 0.39, p<0.001), but not near stereoacuity, and the clinic distance control with near alignment (r = 0.16, p<0.02), distance alignment (r = 0.27, p<0.001) and distance stereoacuity (r = -0.25, p<0.03). A high (poor) NCS (> or =4) at the latest follow-up predicted surgery (p<0.001, OR 29.3, 95% CI 6.2 to 138.7).
Conclusion:
The NCS is a useful measure of the clinical severity of X(T), can be used to serially assess improvement or deterioration and is a useful tool for the management of these patients.
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...