Everyday Consequences of Childhood Intermittent Exotropia

To assess the impact of intermittent exotropia (IXT) on eye-related quality of life (ERQOL), reading speed, motor skills, and self-perception in children.

Fifty-one children with basic or pseudo divergence excess IXT (4-13y) were assessed with the triple office control score, a graded clinical measure of exotropia control. Children with IXT also completed at least one of four behavioral evaluations, including ERQOL (PedEyeQ), reading speed (Readalyzer), motor skills (Movement Assessment Battery for Children-2), and self-perception (Self-perception Profile for Children), along with visual acuity and stereoacuity. Results were compared to those of age-matched controls (n = 353) and associations with IXT control score were analyzed.

Children with IXT and their parent had significantly lower ERQOL scores in all domains compared to controls (Ps < .001). Reading speed was comparable to controls (p = .66). However, children with IXT showed poorer Manual Dexterity (Ps < .001) and Aiming and Catching motor skills (p = .009) in older children. Older children reported lower self-perception in Scholastic competence, Social competence, Athletic competence, and Physical appearance domains (Ps < .05). Worse IXT control scores were associated with lower self-perception of Cognitive/Scholastic competence and Maternal acceptance.

Children with IXT experience reduced ERQOL, impaired motor skills, and lower self-perception. These findings highlight the broad developmental impact of IXT, beyond visual function.