Treatment of sensory XT is directed toward
improving the cosmetic appearance by means of
surgical correction since, in most instances,
the very nature of sensory exotropia precludes
restoration of binocular function.
An exception
to this is children with unilateral congenital
or traumatic cataracts of postnatal development.
In such patients, the graual onset of an
exotropia heralds disruption of fusion, and
cataract surgery should be performed without
delay, followed by contact lens correction,
occlusion treatment for the amblyopia, and
eventually by strabismus surgery. The longer the
deviation is allowed to persist, the less
likelihood there is of binocular vision being
restored after successful cataract surgery,
especially in adults with acquired cataract When
the patient is blind in one eye and therapy is
aimed only at improving the cosmetic appearance.
However, most patients require surgery, and an
operation should not be discouraged because of
the remote chance that the eye may eventually
straighten spontaneously or even become exotropic. If that occurs, additional surgery
can be performed. There is no need for a patient
to go through adolescence with a severe cosmetic
handicap that will invariably have a negative
psychological effect.
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