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Evidence-based Nomenclature for Classification, Diagnosis, and Management of Infantile Exotropia
Seung-Hyun Kim1, Soo Hyun Kim1, Daniel Jinhag Baik1
1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
Insights
Nomenclature for infantile exotropia (a condition developing before 12 months) is confusing. This review proposes three categories: primary, early-onset intermittent, and secondary infantile exotropia for clearer diagnosis.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Infantile exotropia, developing before 12 months, lacks a clear nomenclature.
- Controversy exists regarding its relationship to infantile esotropia and early-onset intermittent exotropia.
Purpose of the Study:
- To critically review existing nomenclature systems for infantile exotropia.
- To propose modifications and a new classification system for infantile exotropia.
Main Methods:
- Review of previous nomenclature systems for infantile exotropia.
- Analysis of clinical characteristics and diagnostic criteria.
Main Results:
- Proposed three diagnostic categories: primary infantile exotropia, early-onset intermittent exotropia, and secondary infantile exotropia.
- Stereopsis is identified as a valuable tool for differentiating primary infantile exotropia and early-onset intermittent exotropia.
Conclusions:
- The proposed classification aims to reduce confusion in infantile exotropia diagnosis.
- Further research is required for precise clinical descriptions, optimal surgical timing, and management strategies.
Abstract:
Despite extensive research on clinical characteristics, patient management, and surgical outcomes of intermittent exotropia, there remains significant confusion regarding the nomenclature system for infantile exotropia, which develops before 12 months of age. Additionally, there still is a controversy over whether infantile exotropia represents the phenotypic counterpart of infantile esotropia or early-onset intermittent exotropia. In this article, we critically review the previous nomenclature systems and propose some modifications to the current classifications of infantile exotropia. These include three diagnostic categories: primary infantile exotropia, early-onset intermittent exotropia, and secondary infantile exotropia. Stereopsis is valuable for differentiation between primary infantile exotropia and early-onset intermittent exotropia. However, further research is needed for more precise descriptions of their clinical features, optimal surgical timing, and proper management.
