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The Relationship Between Deviation Control and Accommodative Load in Patients with Intermittent Exotropia.

Pegah Behjati1, Payam Nabovati1, Mohammad Etezad Razavi2

  • 1Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Journal of Ophthalmic & Vision Research
|March 12, 2026
PubMed
Summary

In intermittent exotropia (IXT), poorer deviation control correlates with larger deviation angles. Accommodative load increases with near fixation but doesn't significantly differ across deviation control groups.

Keywords:
Intermittent ExotropiaAccommodative LoadDeviation Control

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Area of Science:

  • Ophthalmology
  • Vision Science
  • Pediatric Ophthalmology

Background:

  • Intermittent exotropia (IXT) is a common childhood strabismus characterized by outward deviation of the eyes.
  • Understanding factors influencing deviation control is crucial for managing IXT.
  • Accommodative load, the effort the eye expends to focus, may play a role in IXT control.

Purpose of the Study:

  • To investigate the relationship between the level of deviation control and accommodative load in patients diagnosed with intermittent exotropia (IXT).

Main Methods:

  • 35 patients with IXT (ages 5-21) with 20/20 visual acuity were included.
  • Examinations included refraction, deviation angle measurement, stereoacuity, and deviation control assessment with best optical correction.
  • Univariate logistic regression was used to analyze the relationship between accommodative load and deviation control.

Main Results:

  • Deviation control significantly worsened with increasing deviation angles (P=0.012).
  • Accommodative load did not significantly differ across good, relatively good, and poor deviation control groups.
  • No statistically significant relationship was found between accommodative load and deviation control level.

Conclusions:

  • Deviation control in IXT diminishes as the deviation angle increases.
  • While accommodative load tends to be higher in near fixation, it does not significantly vary across different levels of deviation control in IXT patients.