Long Term Results of Part-Time Occlusion for Intermittent Exotropia
Pamela H. Berg. C.O.
Mauricio J. Lozano, M.D.
Sherwin J. Isenberg, M.D.
Numerous therapies have been implemented to treat intermittent exotropia, including pharmacological penalization, minus lenses, orthoptics and visual training, prisms and surgery. We have been impressed with the effectiveness of part time occlusion of the dominant eye for patients with unilateral intermittent exotropia.
We followed 29 patients who were patched for intermittent exotropia from 12 to 120 months. Occlusion of the preferred eye was initiated at six hours per day and then modified as indicated by the clinical course. Family history, age of strabismus onset and initial occlusion, visual acuity, retinoscopy, deviation at distance and near, and near stereopsis were analyzed.In successful occlusion cases, the exotropia was reduced significantly (p = 0.0005). Those patients who had surgery because occlusion failed to control the exotropia had an earlier onset of exotropia (p = 0.012) and a longer interval between onset of strabismus and initiation of occlusion (p = 0.046).Occlusion therapy remains a viable treatment option for some patients with intermittent exotropia. Forty-eight percent in our series were controlled with patching with an average follow up of 66 months. The prognosis for occlusion therapy was better in patients with a later onset of exotropia who began occlusion earlier.© 1998 The Board of Regents of the University of Wisconsin System