Exotropia is a type of eye misalignment that refers to an outward deviation of the eyes. Although Exotropia commonly begins around age 2 to 4 years, it can appear even before 2 years of age due to some eye problems causing visual deficiency like cataract, retina problems.

A noticeable outward deviation of the eyes is usually the primary sign. Initially, this form of strabismus may only be seen when your child is tired or not feeling well. Typically

the deviation is noted more when the child looks in the distance and not as much when viewing close objects. Your child may be seen squinting or rubbing one of the eyes. A child  with  exotropia  may  close  one  eye  particularly  in  bright  sunlight environment. Some children will complain of double vision.

Eye muscle surgery to improve ocular alignment is generally recommended if one or more of the following criteria are present:

• If the exotropia is present for more than 50% of each day.
• If the frequency of the exotropia is definitely increasing over time although it is not yet apparent for 50% of each day.
• If there is a significant exotropia when your child intently views objects at near.
• If there is evidence that your child is losing “binocular vision.” This refers to the brain’s ability to use both eyes together as a single unit which helps in optimal depth perception.

If none of these criteria are met, surgical intervention is generally not recommended and simple observation with or without some form of eyeglass and/or patching therapy is then warranted.

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