The surgical management of intermittent exotropia in adults

Most studies of intermittent exotropia deal primarily with children. However, the manifestations of this disorder in adults differ considerably from those in children. The case records of 44 adults (ages 15-70) who underwent surgery for intermittent exotropia were analyzed. These patients experienced a variety of preoperative symptoms including diplopia, headache, difficulty with reading, and ocular fatigue or pain. Cosmesis was a rare presenting complaint. The authors recommend that surgery in adults be conservative, aiming at slight undercorrection. Surgical management was successful in 41 of 44 patients. All patients with postoperative exodeviations under 15 delta had complete resolution of symptoms. Most patients with larger residual exodeviations did not improve symptomatically; patients with postoperative exodeviations tended to experience persistent diplopia.