Intermittent Divergent Squint in Prematurity and Its Neurophysiological Aspects

Area of Science:

• Ophthalmology
• Neuroscience

Background:

• Intermittent distance exotropia involves outward eye deviation at distance, with normal near function.
• Prematurity increases the risk of various ocular conditions, including exotropia.
• Patients may exhibit eye closure or divergence in specific situations like sunlight or fatigue.

Purpose of the Study:

• To report a case of intermittent distance exotropia in a preterm child.
• To review the neurophysiological aspects, etiopathogenesis, classification, and management of intermittent exotropia.

Main Methods:

• A 5-year-old girl with a history of prematurity and intermittent eye deviation was examined.
• Diagnosis of divergence excess intermittent exotropia with a normal accommodative convergence to accommodation ratio was established.
• Surgical correction involved bilateral lateral rectus recession using the hang-back technique.

Main Results:

• Postoperative assessment revealed normal eye alignment, achieving orthotropia.
• The surgical intervention effectively corrected the intermittent exotropia.

Conclusions:

• Bilateral lateral rectus recession is an effective surgical management for divergence excess intermittent exotropia.
• Understanding the neurophysiological underpinnings is crucial for managing intermittent exotropia.