\u201cIt only happens sometimes.\u201d This is a phrase frequently heard in strabismus consultations. Parents notice that one of their child’s eyes occasionally turns outward: at the end of the day, when they are distracted, when watching television from a distance, or in certain photographs. The rest of the time, the eyes appear perfectly straight, making it easy to assume that it is nothing to worry about.<\/p>\n
In many cases, this is intermittent exotropia<\/strong>, one of the most common types of strabismus in childhood. It can also occur or become noticeable in adults.<\/p>\n How to Recognise It<\/strong><\/p>\n Why It Should Not Be Ignored<\/strong><\/p>\n When the eyes are straight, the brain makes an effort to keep them aligned. This is known as control<\/strong>. In some cases, control remains stable for years, but in others it gradually deteriorates: the eye turns outward more and more frequently, and the deviation may eventually become constant.<\/p>\n What is at stake is binocular vision<\/strong>, the ability to use both eyes together and perceive depth. A child may have good vision in each eye individually and yet fail to use both eyes together when one eye turns outward. This is why it is important to assess how the condition progresses over time, rather than simply measuring the degree of deviation at a particular moment.<\/p>\n How Is It Diagnosed?<\/strong><\/p>\n A comprehensive eye examination is required, including visual acuity testing for each eye, a refraction assessment using eye drops to relax the focusing muscles, measurement of the deviation at both distance and near, evaluation of the degree of control, and assessment of binocular vision.<\/p>\n Video-oculography<\/strong> also makes it possible to objectively record eye movements, which is particularly useful for comparing results between follow-up appointments.<\/p>\n Because the condition can vary from one day to the next, regular monitoring is an essential part of the diagnostic process.<\/p>\n How Is It Treated?<\/strong><\/p>\n Not all cases of intermittent exotropia require surgery. Depending on the individual case, the specialist may recommend:<\/p>\n\n