obsolete intermittent alternating exotropia

Intermittent alternating exotropia, also known as alternating exotropia, is a type of strabismus where the eyes deviate outward in an alternating manner. This means that at different times, one eye will turn outward while the other eye remains straight, and vice versa.

Characteristics:

• The deviation occurs intermittently, meaning it may appear and disappear at various times.
• The eyes alternate between being straight and turned outward.
• The degree of exotropia can vary from mild to severe.

Causes and Risk Factors:

While the exact causes of intermittent alternating exotropia are not fully understood, research suggests that it may be related to:

• Genetics: Family history plays a significant role in the development of strabismus.
• Neurological factors: Abnormalities in the brain's control over eye movement can contribute to strabismus.
• Muscle imbalance: Weakness or overactivity of the extraocular muscles can lead to misalignment.

Symptoms and Diagnosis:

The symptoms of intermittent alternating exotropia may include:

• Intermittent deviation: The eyes turn outward at different times, often when the person is tired, sick, or daydreaming.
• Alternating vision: One eye may appear straight while the other eye turns outward.

Diagnosis typically involves a comprehensive eye examination by an ophthalmologist or optometrist to rule out other conditions and assess the degree of exotropia.

Treatment Options:

While there is no cure for intermittent alternating exotropia, various treatment options are available to manage the condition:

• Glasses: Corrective lenses can help alleviate symptoms in some cases.
• Vision therapy: A type of physical therapy that targets eye movement and coordination.
• Surgery: In severe cases, surgery may be necessary to correct the muscle imbalance.

It's essential to consult with an eye care professional for a proper diagnosis and treatment plan.

Understanding Obsolete Intermittent Alternating Exotropia

Intermittent alternating exotropia, also known as intermittent exotropia, is a type of strabismus where one eye turns outward intermittently. This condition can be constant or intermittent and varies in severity.

Common Signs and Symptoms:

• Outward Eye Deviation: The hallmark symptom of alternating exotropia is the outward deviation of one eye, which alternates between the left and right eyes.
• Transient Diplopia: Patients may experience transient double vision when the affected eye turns outward.
• Asthenopic symptoms: Symptoms like eyestrain, blurring, headache, and difficulty with prolonged periods of reading can occur due to the intermittent deviation.

Other Possible Signs:

• Gradual loss of fusional control evidenced by increasing frequency of the manifest phase of the strabismus
• Increasing frequency of the outward eye turn when fatigued, ill, or in a lowered mental state

Important Notes:

• Intermittent alternating exotropia is considered an obsolete term and has been replaced by more specific classifications.
• The condition can be managed with proper diagnosis, treatment, and vision therapy.

References:

[4] [5] [6] [9] [12]

Intermittent alternating exotropia, also known as "obsolete" intermittent alternating exotropia, is a type of strabismus characterized by an intermittent outward deviation of the eyes that alternates between the two eyes. The diagnostic tests for this condition are crucial in determining the presence and severity of the exotropia.

According to various sources [3][4][11], the following diagnostic tests can be used to diagnose intermittent alternating exotropia:

• Cover test: This is a fundamental test used to assess eye alignment and detect strabismus. It involves covering one eye with an occluder or finger, while the other eye fixates on a target. The examiner then observes whether the uncovered eye deviates outward (exotropia) or inward (esotropia).
• Prism cover test: This is a variation of the cover test that uses prisms to measure the amount of exodeviation. It involves placing a prism over one eye, while the other eye fixates on a target. The examiner then measures the angle of deviation using a prism bar.
• Control score: This is a scoring system used to assess the control of intermittent alternating exotropia. A higher control score indicates better control of the exotropia.
• Convergence test: This test assesses the ability of the eyes to converge (move inward) when fixating on a near target.

In addition to these tests, other diagnostic tools such as visual acuity testing, ocular alignment assessment, and binocular vision assessment may also be used to evaluate patients with intermittent

Based on the provided context, it appears that there are various treatment options for intermittent exotropia, a form of strabismus characterized by an intermittent outward deviation of the eyes.

Treatment Options:

• Botulinum toxin injections: According to search result [6], Botulinum toxin A (BTA) intramuscular injections have been used as an alternative or adjunct to muscle weakening procedures for treating intermittent exotropia.
• Patching one eye: Some doctors still advocate patching one eye, although patching does not help the person with intermittent exotropia according to search result [5].
• Optical correction: Search result [3] mentions that prescription of myopic spectacles is another method of passive vision therapy used for intermittent exotropia.
• Vision therapy: Treatments for strabismus, including intermittent exotropia, involve lenses, prisms, and vision therapy according to search results [8] and [10].
• Surgery: Surgery (bilateral lateral rectus resection) is also a viable alternative for treating intermittent exotropia as mentioned in search result [2].

Effectiveness of Botulinum Toxin:

Botulinum toxin injections have been found to be at least as effective as surgical outcomes reported previously for the treatment of intermittent exotropia in children, particularly those between 2 and 4.5 years of age (search result [11]).

Current Nonsurgical Treatment:

A presentation titled "Current Nonsurgical Treatment of Intermittent Exotropia" mentions that patching and observation are reasonable treatment options in the first 6 months of disease presentation, but nonsurgical management may fail as the disease progresses (search result [12]).

It's worth noting that the effectiveness of these treatments can vary depending on individual cases and age groups.

Based on the provided context, it appears that differential diagnosis for obsolete intermittent alternating exotropia would involve considering various conditions that may present similarly to this condition.

• Duane Syndrome: This is a congenital strabismus syndrome characterized by limited eye movement and often associated with other systemic anomalies. It can manifest as an alternating esotropia or exotropia, making it a potential differential diagnosis for obsolete intermittent alternating exotropia [12].
• Brown Syndrome: This is another congenital strabismus syndrome that affects the superior oblique muscle, leading to limited elevation of the affected eye. It can present with alternating esotropia or exotropia, and its similar presentation makes it a differential diagnosis for obsolete intermittent alternating exotropia [12].
• Monocular Elevation Deficiency: This is a condition where one eye has limited elevation, which can lead to an apparent strabismus. It can present with alternating esotropia or exotropia, and its similar presentation makes it a differential diagnosis for obsolete intermittent alternating exotropia [12].
• Consecutive Exotropia: This is a type of strabismus that develops as a result of previous eye surgery or other ocular conditions. It can present with alternating esotropia or exotropia, and its similar presentation makes it a differential diagnosis for obsolete intermittent alternating exotropia [14].

It's essential to note that these conditions may require further evaluation and testing to confirm the diagnosis. A comprehensive ophthalmological examination, including cover tests, prism cover tests, and other diagnostic tools, would be necessary to rule out these differential diagnoses.

References: [12] - Context result 12 [14] - Context result 14