Exotropia: Definition, Types, Symptoms, Complications, Causes, Diagnosis and Treatment

It is a type of strabismus, which is a misalignment of the eyes.

Exotropia belongs to a condition in which one or both eyes turn out from the nose. It is the opposite of crossed eyes .

While it can affect anyone at any age, it is commonly diagnosed at a young age and accounts for up to 25 percent of all eye misalignments in young children.

Types of exotropia

This condition can be classified as follows:

  • Congenital exotropia : Also known as infantile exotropia. People with this condition have an outward turning of the eye or eyes from birth or early childhood.
  • Sensory exotropia – Poor vision in the eye causes it to turn outward and not work in tandem with the straight eye. This type of exotropia can occur at any age.
  • Acquired exotropia: is the result of disease, trauma, or other health problems, particularly those that affect the brain. For example, stroke or Down syndrome can increase the risk of developing this condition.
  • Intermittent exotropia – This is the most common form of the condition. Intermittent exotropia causes the eye to sometimes roll outward, often when tired, ill, daydreaming, or looking into the distance. Other times, the eye is kept straight.


Eyes that don’t focus and work in concert with each other can cause a variety of problems with vision and physical health.

In the case of vision, when the eyes are not focused together, two different visual images are sent to the brain. One image is what the right eye sees and the other is what the turned eye sees.

To avoid double vision, amblyopia or lazy eye occurs and the brain ignores the image of the rolled eye. This can cause the rolled eye to become weak and lead to impaired or loss of vision.

Therefore, a brief description of the symptoms that are indicative of this condition is presented below:

  • One or both eyes turning outward.
  • Frequent rubbing of the eyes.
  • Squinting or covering one eye when looking in bright light or trying to see objects that are far away

Complications of exotropia

This visual condition can also generate complications in the short or long term, of which can be listed:

  • Headaches.
  • Trouble reading
  • Visual fatigue
  • Blurry vision.
  • Poor 3-D vision.

Nearsightedness is also common in people with this condition. According to some studies, more than 90 percent of children with intermittent exotropia become myopic in their 20s.


Exotropia occurs when there is an imbalance in the eye muscles or when there is a signaling problem between the brain and the eye. Sometimes a health problem, such as cataracts or a stroke, can cause this to occur. The condition can also be inherited.

About 30 percent of children with strabismus have a family member with this condition. When no family history, diseases, or conditions can be identified, doctors are unsure what causes a strabismus such as exotropia.

Diagnosis of exotropia

Diagnosis is usually based on family history and vision tests. An ophthalmologist or optometrist, doctors who specialize in eye problems, are better equipped to diagnose this disorder.

Among the tests that are carried out are:

  • Read charts from an eye chart.
  • Place a series of lenses in front of the eyes to see how light refracts.
  • Tests that look at how the eyes are focused.


When eye misalignment occurs early in life and drift is rare, your doctor may recommend just looking and waiting.

Treatment may be recommended if drift begins to worsen or does not improve, especially in a young child whose vision and eye muscles are still developing.

The goal of treatment is to get the eyes aligned as much as possible and to improve vision. Treatments include:

  • Glasses: help correct farsightedness or farsightedness will help keep the eyes aligned.
  • Patches: People with exotropia tend to favor the aligned eye, so vision in the outward eye can be weakened, resulting in amblyopia (lazy eye). To improve strength and vision in the misaligned eye, some doctors recommend patching the “good” eye for several hours a day to encourage you to use the weaker eye.
  • Exercises – Your doctor may suggest a variety of eye exercises to improve focus.

In some cases, he may also recommend surgery to readjust the eye muscles. The surgery is performed under general anesthesia for a child and with a local anesthetic for an adult. Sometimes the surgery must be repeated.

In adults, surgery usually does not improve vision. Instead, an adult may choose to have surgery to make their eyes appear straight.