Socio-demographic distribution and clinical profile of exotropia in India: Electronic medical records-driven big data analytics report

To describe the demographics and clinical profile of exotropia from patient data obtained from a multi-tiered ophthalmology hospital network in India.

This cross-sectional hospital-based study included the data of 2,664,906 patients presenting to the hospital network from August 1, 2010 to January 31, 2021. Data were collected using an electronic medical record system. Data were collected regarding demographics, age at presentation, vision assessment with complete ophthalmic evaluation, and strabismus assessment.

During this period, 31,333 (1.18%) patients were diagnosed with exotropia. There was an insignificant male predominance (54.68%) and a significant association with higher socioeconomic status (82.21%). The mean age of patients was 23 ± 19.66 years. However, most presented with exotropia in the first decade of life (10,904, 34.8%). Majority of the subjects with exotropia were students (16,109, 51.41%). Majority of (13,147, 41.96%) the patients were from rural areas. The most common type of exotropia was constant exotropia (12,106, 38.64%), followed by intermittent exotropia (11,574, 36.94%), secondary exotropia (4533, 14.47%), and congenital exotropia (1752, 5.59%). Associated pattern strabismus was seen in a minority (V-pattern: 457, 1.46%; A-pattern: 128, 0.41%) of patients. Extraocular muscle surgery was performed on 4477 (14.29%) patients.

Exotropia was more common in males who presented to our hospital in their first decade of life. As this is the most crucial age for binocular vision and sensory development, early and timely screening by trained pediatric ophthalmologists is a must in schools. This analysis showed that only a tenth of the affected patients underwent surgical correction to treat exotropia.