Control Scoring in Intermittent Exotropia: A Descriptive Study in a Pediatric Population

Published: October 20, 2024

Authors

Rajesh Kumar, MalharVyas, Neebha Passi, and Manish Kumar Prajapat

Keywords

Abstract

Background: Intermittent exotropia (IXT) is a condition characterized by fluctuating control, and the optimal approach for monitoring it is a subject of continual discussion.

Purpose: The aim of this study is to assess the reliability of repeated measurements of the Office Control Score (OCS) and its correlation with distance stereopsis in children diagnosed with intermittent exotropia (IXT).

Methods: This prospective study involved 98 children, who were categorized according to deviation angle (<20 PD and ≥20 PD). OCS was assessed at three time points, and stereopsis was evaluated through the Titmus and Distance Randot tests.

Results: Results indicate that both groups exhibited statistically significant improvements in OCS across visits, with Group A showing superior control and stereopsis outcomes at the third visit (P < 0.05). Children with smaller deviation angles exhibited significantly improved distance stereopsis.

Conclusions: Multiple OCS measurements, as opposed to a single-point assessment, offer a more stable and reliable approach for monitoring control in IXT. This method may facilitate prompt surgical referrals and enhance clinical outcomes.

References

  • Ale Magar, J. B., Shah, S., Sleep, M., Felius, J., & Patel, V. (2023). Assessment of distance-near control disparity in basic and divergence excess pediatric intermittent exotropia. Clinical and Experimental Optometry, 106(8), 901–904. https://doi.org/10.1080/08164622.2022.2122703
  • Gore, J., Rath, S., & Ganesh, S. (2023). Clinical profile of childhood exotropia in a tertiary eye care center in North India. Indian Journal of Ophthalmology, 71(12), 3637–3641. https://doi.org/10.4103/IJO.IJO_29_23
  • Hatt, S. R., Haggerty, H., Buck, D., Donahue, S. P., & Holmes, J. M. (2007). Distance stereoacuity in intermittent exotropia. British Journal of Ophthalmology, 91(2), 219–221. https://doi.org/10.1136/bjo.2006.099465
  • Hatt, S. R., Kraker, R. T., Leske, D. A., & Holmes, J. M. (2023). Improved control of intermittent exotropia with part-time patching. Journal of AAPOS, 27(3), 160–163. https://doi.org/10.1016/j.jaapos.2023.02.011
  • Hatt, S. R., Leske, D. A., Liebermann, L., & Holmes, J. M. (2012). Variability of angle of deviation measurements in children with intermittent exotropia. Journal of AAPOS, 16(2), 120–124. https://doi.org/10.1016/j.jaapos.2011.11.008
  • Hatt, S. R., Liebermann, L., Leske, D. A., & Holmes, J. M. (2011). Improved assessment of control in intermittent exotropia using multiple measures. American Journal of Ophthalmology, 152(5), 872–876. https://doi.org/10.1016/j.ajo.2011.05.007
  • Hatt, S. R., Mohney, B. G., Leske, D. A., & Holmes, J. M. (2008). Variability of control in intermittent exotropia. Ophthalmology, 115(2), 371–376.e2. https://doi.org/10.1016/j.ophtha.2007.03.084
  • Jin, H. C., Lee, Y. C., & Lee, S. Y. (2012). Relationship between control grade and stereoacuity in basic intermittent exotropia. Journal of the Korean Ophthalmological Society, 53(1), 133–137. https://doi.org/10.3341/jkos.2012.53.1.133
  • Jung, J. W., & Lee, S. Y. (2010). A comparison of the clinical characteristics of intermittent exotropia in children and adults. Korean Journal of Ophthalmology, 24(2), 96–100. https://doi.org/10.3341/kjo.2010.24.2.96
  • Kang, K. T., & Lee, S. Y. (2015). Relationship between control grade, stereoacuity, and surgical success in basic intermittent exotropia. Korean Journal of Ophthalmology, 29(3), 173–177. https://doi.org/10.3341/kjo.2015.29.3.173
  • Kaur, K., & Gurnani, B. (2024). Intermittent exotropia. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK572077/
  • Kumar, R., & Phogat, D. J. (2024). Vision therapy for amblyopia with intermittent exotropia: A case report. International Journal of Ophthalmology and Optometry, 6(2), 1–6. https://doi.org/10.33545/26648547.2024.v6.i1a.31
  • Lim, S. B., Wong, W. L., Ho, R. C., Lim, L. S., & Wong, T. Y. (2015). Childhood intermittent exotropia from a different perspective: Does severity impact quality of life? British Journal of Ophthalmology, 99(10), 1405–1411. https://doi.org/10.1136/bjophthalmol-2014-306545
  • Mohney, B. G., & Holmes, J. M. (2006). An office-based scale for assessing control in intermittent exotropia. Strabismus, 14(3), 147–150. https://doi.org/10.1080/09273970600894716
  • Oh, J. S., Jung, J. H., & Shin, H. J. (2023). Quality of life in intermittent exotropia for Korean children and their parents. BMC Ophthalmology, 23(1), 185. https://doi.org/10.1186/s12886-023-02919-z
  • Pan, C. W., Zhu, H., Yu, J. J., Wang, Y., Wang, J., & Li, Y. (2016). Epidemiology of intermittent exotropia in preschool children in China. Optometry and Vision Science, 93(1), 57–62. https://doi.org/10.1097/opx.0000000000000754
  • Romanchuk, K. G., Dotchin, S. A., & Zurevinsky, J. (2006). The natural history of surgically untreated intermittent exotropia—Looking into the distant future. Journal of AAPOS, 10(3), 225–231. https://doi.org/10.1016/j.jaapos.2006.02.006
  • Stathacopoulos, R. A., Rosenbaum, A. L., Zanoni, D., & Freeman, R. S. (1993). Distance stereoacuity: Assessing control in intermittent exotropia. Ophthalmology, 100(4), 495–500. https://doi.org/10.1016/s0161-6420(93)31616-7
  • Wang, C., Wang, L., Ren, M., Zhu, X., & Wang, Y. (2017). Far distance control scores for assessing intermittent exotropia. Journal of AAPOS, 21(4), 278–281. https://doi.org/10.1016/j.jaapos.2017.04.007
  • Wang, Y., Xu, M., Yu, H., Li, X., & Chen, J. (2020). Health-related quality of life correlated with the clinical severity of intermittent exotropia in children. Eye, 34(2), 400–407. https://doi.org/10.1038/s41433-019-0557-1
  • Wang, Y., Zhao, A., Zhang, X., Liu, Z., & Sun, W. (2021). Prevalence of strabismus among preschool children in eastern China and comparison at a 5-year interval: A population-based cross-sectional study. BMJ Open, 11(10), e055112. https://doi.org/10.1136/bmjopen-2021-055112

How to Cite

Rajesh Kumar, MalharVyas, Neebha Passi, and Manish Kumar Prajapat. Control Scoring in Intermittent Exotropia: A Descriptive Study in a Pediatric Population. J. Multidiscip. Res. Healthcare. 2024, 11, 20-25
Control Scoring in Intermittent Exotropia: A Descriptive Study in a Pediatric Population

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ISSN Print2393-8536
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RNI No.CHAENG/2014/57978

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Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at https://jmrh.chitkara.edu.in/

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