American Orthoptic Journal
Fresnel Prism and Lens Co.
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Amer. Orthoptic Jrnl. 59(1):18-25 (2009); doi:10.3368/aoj.59.1.18
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Symposium: Drifting Apart from Birth to Adulthood: How to Manage Exotropia

Does Nonsurgical Treatment of Exodeviations Work?

Virginia Karlsson, C.O., C.O.M.T.

From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota

Correspondence: Requests for reprints should be addressed to: Virginia Karlsson, C.O., C.O.M.T., Department of Ophthalmology W7, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.


    Abstract
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 Abstract
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There are proven successful nonsurgical treatments for exodeviations, and, very specifically, convergence insufficiency. Clinicians have sought nonsurgical treatments for a variety of reasons both their own and their patient’s personal preference. The basic principals of treatment are to correct vision and to remove any obstacles to fusion. The main categories of nonsurgical treatment are: occlusion, glasses (base-in/over-minus), and exercises (fusional convergence, antisuppression, and increasing the near point of convergence). The recently published randomized clinical trial studying which exercise modality is best for treating convergence insufficiency is reviewed.

Key words: exotropia, nonsurgical treatment, convergence insufficiency


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  1. Cooper EL, Leyman IA: The management of intermittent exotropia: A comparison of the results of surgical and nonsurgical treatment. Am Orthopt J 1977; 27:61–67.[Medline]
  2. Eibschitz-Tsimhoni M, et al.: Current concepts in the management of concomitant exodeviations. Comp Ophthalmol Update 2007; 8: 213–223.
  3. Pejic Z, et al.: Fusion exercises for treatment if intermittent exotropia and phoria. Am Orthopt J 2006; 56:138–146.[CrossRef]
  4. Rawson JA, Burley CD, Elder MJ: A systematic review of the applicability and efficacy of eye exercises. J Pediatr Ophthalmol Strabismus 2005; 42:82–88.[Medline]
  5. Kushner BJ, Morton GV: Distance/near differences in intermittent exotropia. Arch Ophthalmol 1998; 116:478–486.[Abstract/Free Full Text]
  6. Kushner BJ: Diagnosis and treatment of exotropia with a high accommodation convergence-accommodation ratio. Arch Ophthalmol 1999; 117:221–224.[Abstract/Free Full Text]
  7. Ding SH, Zuo J: [Acupuncture for treatment of 40 cases of convergence insufficient asthenopia with exotropia] [article in Chinese]. Zhongguo Zhen Jiu 2008; 28:345–347.[Medline]
  8. Goldrich SG: Oculomotor biofeedback therapy for exotropia. Am J Optom Physiol Opt 1982; 59:306–317.[Medline]
  9. Sturm V, Berger RW, Zangemeister WH: Alcohol as an alternative therapy in accommodative and convergence insufficiency. Can J Ophthalmol 2007; 42:880.[CrossRef][Medline]
  10. Freeman RS, Isenberg SJ: The use of part-time occlusion for early onset unilateral exotropia. J Pediatr Ophthalmol Strabismus 1989; 26: 94–96.[Medline]
  11. Berg PH, Isenberg SJ: Treatment of unilateral exotropia by part-time occlusion. Am Orthopt J 1991; 41:72–77.
  12. Reynolds JD, Wackerhagen M, Olitsky SE: Over-minus lens therapy for intermittent exotropia. Am Orthopt J 1994; 44:86–91.
  13. Caltrider N, Jampolsky A: Overcorrecting minus lens therapy for treatment of intermittent exotropia. Ophthalmology 1983; 90:1160–1165.[Medline]
  14. Scheiman M, et al.the Convergence Insufficiency Treatment Trial (CITT) Study Group: Randomised clinical trial of the effectiveness of base-in prism reading glasses versus placebo reading glasses for symptomatic convergence insufficiency in children. Br J Ophthalmol 2005; 89:1318–1323.[Abstract/Free Full Text]
  15. Newman J, Mazow ML: Intermittent exotropia: Is surgery necessary? Ophthalmic Surg 1981; 12:199–202.[Medline]
  16. Knapp P, Moore S: Intermittent exotropia. Am Orthopt J 1960; 10:118–122.[Medline]
  17. Gallaway M, Scheiman M, Malhotra K: The effectiveness of pencil pushups treatment for convergence insufficiency: A pilot study. Optom Vis Sci 2002; 79:265–267.[CrossRef][Medline]
  18. Richardson S, Gnanaraj L: Interventions for intermittent distance exotropia. Cochrane Database Syst Rev 2003; (2):CD003737.
  19. Berg PH, Lozano MJ, Isenberg SJ: Long-term results of part-time occlusion for intermittent exotropia. Am Orthopt J 1998; 48:85–89.
  20. Sanfilippo S, Clahane AC: The effectiveness of orthoptics alone in selected cases of exodeviation: The immediate results and several years later. Am Orthopt J 1970; 20:104–117.[Medline]
  21. Mohney BG, Holmes JM: An office-based scale for assessing control in IXT. Strabismus 2006; 14:147–150.[CrossRef][Medline]
  22. Haggerty H, et al.: The Newcastle control score: A new method of grading the severity of intermittent distance exotropia. Br J Ophthalmol 2004; 88:233–235.[Abstract/Free Full Text]
  23. Petrunak JL, Rao R: The evaluation of office control in intermittent exotropia: A systematic approach. Am Orthopt J 2003; 53:98–104.[CrossRef]
  24. Holmes JM, et al.: New tests of distance stereoacuity and their role in evaluating intermittent exotropia. Ophthalmology 2007; 114:1215–1220[CrossRef][Medline]
  25. Convergence Insufficiency Treatment Trial Study Group: Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol 2008; 126:1336–1349.[Abstract/Free Full Text]
  26. Scheiman M, et al.: A survey of treatment modalities for convergence insufficiency. Optom Vis Sci 2002; 79:151–157.[CrossRef][Medline]
  27. Convergence Insufficiency Treatment Trial Study Group: The convergence insufficiency treatment trial: Design, methods, and baseline data. Ophthalmic Epidemiol 2008; 15:24–36.[Medline]
  28. Wallace DK: Treatment options for symptomatic convergence insufficiency. Arch Ophthalmol 2008; 126:1455–1456.[Free Full Text]




This Article
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