Constant exotropia is less common than intermittent exotropia. It may be present at birth or may develop from an intermittent exotropia. Onset later in life is asssociated with loss of vision in one eye, for example, following surgical correction of esotropia - consecutive exotropia.
Usually, there is limited adduction and stereopsis is lost. A hypertropia may accompany the exotropia. Often, suppression occurs if the condition was acquired by the age of 6-8 years, otherwise there is diplopia. Abnormal retinal correspondence is rare if there is suppression. Amblyopia is uncommon in the absence of anisometropia. Spontaneous alternation of the fixating eye is frequently observed.
Surgical correction is indicated. An overcorrection is usual since recurrence is common. Botulinum toxin injections may be given if the deviation is small or to help prevent recurrence.
Last reviewed 01/2018