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Preoperative Testing for Exotropia

From the Krieger Children’s Eye Center at the Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Correspondence: Requests for reprints should be addressed to: Alex Christoff, C.O., C.O.T., Krieger Children’s Eye Center at the Wilmer Institute, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD 21287.

The conservative goals of any preoperative assessment of exotropia are first and foremost to accurately predict the target angle, thus avoiding unplanned under- or over-corrections. The clinician also needs to assess the likelihood of prolonged postoperative diplopia, the threat of which may require special patient counseling and perhaps alternatives to strabismus surgery. Clinical considerations gleaned from the exotropia literature, past and present, are discussed in the context of developing a thorough and comprehensive approach to the preoperative assessment of exotropia.

Key words: exotropia, preoperative testing, sensory motor evaluation, postoperative diplopia