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Deviation control that deteriorates with fixation distance in basic-type intermittent exotropia.

Ryota Takada1, Akemi Wakayama2, Fumi Tanabe2

  • 1Department of Ophthalmology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama, Osaka, 589-8511, Japan. taka_r@med.kindai.ac.jp.

BMC Ophthalmology
|August 19, 2025
PubMed
Summary
This summary is machine-generated.

Deviation control in intermittent exotropia (IXT) often worsens at 1 meter, not just at clinical endpoints. Assessing control across multiple fixation distances provides a clearer picture of patient eye alignment stability.

Keywords:
ControlCover testFixation distanceIntermittent exotropia

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Area of Science:

  • Ophthalmology
  • Vision Science
  • Strabismus Research

Background:

  • Clinical assessments for deviation control in intermittent exotropia (IXT) typically use fixed near (30 cm) and far (5-6 m) distances.
  • These standard assessments may not fully capture how patients' eye alignment control fluctuates between these points.

Purpose of the Study:

  • To investigate the variation in deviation control at multiple fixation distances between the standard clinical near and far testing points.
  • To identify specific distances where control deterioration is most prevalent in patients with basic IXT.

Main Methods:

  • Retrospective review of 48 patients with basic IXT treated at Kindai University Hospital.
  • Cover test with refractive correction assessed eye position at 6 fixation distances (30 cm, 1 m, 2 m, 3 m, 4 m, 5 m).
  • Kushner's method (2019) classified control as favorable (excellent/good) or unfavorable (poor/fair); control deterioration was analyzed by distance.

Main Results:

  • 38 out of 48 patients (79%) had favorable baseline control.
  • Of those with deteriorating control, 57% showed worsening at 1 meter, significantly more than at other distances (p < 0.01).
  • Control deterioration was most frequently observed at 1 meter, followed by 3 meters.

Conclusions:

  • Fixation distance significantly impacts deviation control in basic IXT patients.
  • Control most commonly deteriorates at a 1-meter fixation distance.
  • Evaluating control at various intermediate distances offers a more thorough understanding of patient alignment stability.