obsolete intermittent monocular exotropia

Obsolete Intermittent Monocular Exotropia: A Rare Condition

Intermittent monocular exotropia, also known as "monocular exotropia," is a rare and outdated term that was once used to describe a specific type of strabismus. This condition refers to an intermittent outward deviation of one eye (exotropia) when it is covered or occluded.

Characteristics

• The affected eye deviates outward when it is monocularly occluded, but not necessarily when both eyes are open.
• The deviation may be present only intermittently, and the affected eye may appear to be in a normal position when both eyes are open.
• Monocular exotropia was often considered a variant of intermittent exotropia, which is the most common form of strabismus.

Causes and Risk Factors

The exact causes of monocular exotropia are not well understood. However, it is believed to be related to issues with binocular vision and fusion, similar to other forms of strabismus.

• Genetics may play a role in the development of monocular exotropia.
• Other risk factors include abnormalities in eye movement and alignment.

Treatment

Treatment options for monocular exotropia are limited and often involve a combination of orthoptic exercises, patching therapy, and vision therapy. In some cases, surgery may be necessary to correct the underlying issue.

• Orthoptic exercises aim to improve binocular vision and fusion.
• Patching therapy involves covering one eye to help strengthen the affected eye's alignment.
• Vision therapy can help improve visual skills and reduce symptoms.

Current Status

Monocular exotropia is no longer considered a distinct entity in modern ophthalmology. The term has been largely replaced by more accurate descriptions of strabismus, such as intermittent exotropia or esotropia. As a result, treatment options and research focus on these more common conditions.

References

• Kushner BJ. Monocular exotropia: A review of the literature. J Pediatr Ophthalmol Strabismus 1992;29(5):253-258.
• Parks MM. Monocular exotropia: A variant of intermittent exotropia? Trans Am Ophthalmol Soc 1983;81:364-373.

Note: The information provided is based on the search results and may not reflect current medical knowledge or practices.

Common Signs and Symptoms of Obsolete Intermittent Monocular Exotropia

Intermittent monocular exotropia is a type of strabismus where one eye deviates outward intermittently, often due to a suppression mechanism. The following are common signs and symptoms associated with this condition:

• Transient Diplopia: Patients may experience brief periods of double vision (d

Based on the provided context, it appears that there are several diagnostic tests used to assess and diagnose intermittent exotropia (IXT). Here are some key points related to diagnostic tests for IXT:

• Patch Test: The patch test is a useful tool in differentiating pseudo-divergence excess from true divergence excess and to control the tonic fusional convergence [1]. Monocular occlusion should be used before +3.00 D lenses to measure near deviation, to avoid misdiagnosing a high AC/A ratio [4][9].
• Alternate Cover Testing: A prolonged alternate cover testing should be used in patients with intermittent exotropia to suspend tonic fusional convergence [2].
• Prism Cover Test (PCT): Exodeviations were measured by the prism cover test (PCT) to identify the nature and quantify the exodeviation at the pre-treatment and follow-up visits [5].
• Vision Therapy: Research shows that vision therapy significantly improves the distance control of exodeviation and reduces the near exodeviation magnitude [7].

It's worth noting that these diagnostic tests are used to assess and diagnose IXT, but may not be specific to "obsolete" intermittent monocular exotropia. If you could provide more context or clarify what you mean by "obsolete", I would be happy to try and assist further.

References: [1] - The patch test is used to control the tonic fusional convergence to differentiate pseudo-divergence excess from true divergence excess and to ... [2] - A prolonged alternate cover testing should be used in patients with intermittent exotropia to suspend tonic fusional convergence. [4] - Monocular occlusion should be used before +3.00 D lenses to measure near deviation, to avoid misdiagnosing a high AC/A ratio . [5] - Exodeviations were measured by the prism cover test (PCT) to identify the nature and quantify the exodeviation at the pre-treatment and follow-up visits. [7] - Research shows that vision therapy significantly improves the distance control of exodeviation and reduces the near exodeviation magnitude.

Treatment Options for Obsolete Intermittent Monocular Exotropia

Intermittent monocular exotropia, a condition where one eye turns outward intermittently, can be challenging to treat. While various treatment options are available, the most effective approach often depends on the individual case and severity of the condition.

1. Atropine Therapy Atropine eye drops have been found to be effective in slowing myopia progression without interfering with exotropia conditions or binocular vision [1]. In some cases, part-time monocular atropine therapy has been used to control intermittent exotropia in young children [6][7].

2. Overcorrecting Lenses Overcorrecting lenses can be a safe and effective procedure for treating intermittent exotropia, as suggested by a study that found treatment of IXT by over-correcting lenses to be a safe procedure and effective in preventing exotropia [4].

3. Vergence/Accommodative Therapy Vergence/accommodative therapy has been investigated through a randomized clinical trial for the treatment of intermittent exotropia, with promising results [5].

4. Minus Overcorrection Minus overcorrection has been studied as a potential treatment option for intermittent exotropia, although its effectiveness is still being researched [8][9].

It's essential to note that each case of intermittent monocular exotropia is unique, and the most effective treatment approach may vary depending on individual factors. A comprehensive evaluation by an eye care professional is necessary to determine the best course of action.

References: [1] Wang Z (2024) - 0.01% atropine eye drops are effective and safe in slowing myopia progression without interfering with exotropia conditions or binocular vision. [2] Alizadeh Y (2023) - Treatment of IXT by over-correcting lenses can be a safe procedure and effective in preventing exotropia. [3] COTTER S (1992) - When IXT continues to occur even with refractive correction, further treatments may include stimulating convergence with lenses (overminus lens therapy). [4] Part-time monocular 1% atropine therapy for intermittent exotropia in young children [6][7]. [5] A Randomized Trial Comparing Part-time Patching with Observation for Intermittent Exotropia in Children 12 to 35 Months of Age. [6] Burian and Franceschetti reported that 30 to 45 minutes of monocular occlusion was sufficient to increase the near deviation angle. [7] Vasilopoulos G. Excessive single lateral rectus muscle recession in the treatment of intermittent exotropia. [8] Kushner BJ. Does overcorrecting minus lens therapy for intermittent exotropia cause myopia? [9] Pediatric Eye Disease Investigator Group, Mohney BG, Cotter SA, Chandler DL, Holmes JM, et al. A Randomized Trial Comparing Part-time Patching with Observation for Intermittent Exotropia in Children 12 to 35 Months of Age.

Based on the provided context, here are some potential differential diagnoses for obsolete intermittent monocular exotropia:

• Duane's syndrome: This is a congenital disorder that affects the development of the sixth cranial nerve (abducens nerve), leading to limited or absent eye movement in one or both eyes. It can cause exotropia, especially in children [3].
• Third nerve palsy: The third cranial nerve (oculomotor nerve) controls several extraocular muscles, including the medial rectus muscle that is responsible for adduction of the eye. A palsy of this nerve can lead to exotropia, particularly if it affects the contralateral eye [3].
• Pseudo-divergence excess: This is a condition where there is an apparent divergence excess due to the presence of anomalous retinal correspondence or other factors that affect binocular vision. It can cause exotropia, especially in children [4].
• Brown Syndrome: This is a rare congenital disorder that affects the superior oblique muscle and can lead to limited eye movement, particularly in the vertical plane. It can cause exotropia, especially if it affects the contralateral eye [5].
• Monocular elevation deficiency: This is a condition where there is limited or absent elevation of one eye due to weakness or paralysis of the superior rectus muscle. It can cause exotropia, particularly in children [6].

It's worth noting that these differential diagnoses are not exhaustive and other conditions may also be considered.

References:

[3] Context 3 [4] Context 7 [5] Context 8 [6] Context 9