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Case of the week 56 ( May 2012 )
Huge Alternating Exotropia



28 years old young woman asking for cosmetic surgery to her huge out deviation of her eyes
Her parents told that they noticed this deviation at the age of 4 years , this is her first time to be examined by an ophthalmologist
VA 6/6 OD      6/6 OS
both eyes are emmetropic
Random dot stereogram showed no stereopsis


This girl has had an exotropia since early childhood. The angle in the primary position is large, 50 prism diopters . This may be an example of an intermittent exotropia progressing to a constant exotropia over time. Some surgeons feel strongly about operating earlier on exodeviations in infants and toddlers to avoid this.

The surgical treatment is :
1) Large bilateral lateral rectus recession 7.0 to 8.0 mm 
2)  Resection one medial rectus 7.0 mm .

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The Egyptian Site of Strabismus & Oculomotor Disorders