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False appearance of
esotropia when the
visual axes are
actually aligned
Both corneal light
reflex testing and
cover testing are • Flat, broad nasal bridge
normal
Infantile (Congenital) Esotropia
Sensory Esotropia
Monocular vision loss may cause sensory (deprivation)
esotropia.
Obstacles preventing clear and focused retinal images and
symmetric visual stimulation must be identified and
remedied promptly
Divergence Insufficiency
Esodeviation that is greater at distance than at near.
The deviation is comitant in vertical and horizontal gaze, and fusional
divergence is reduced.
Management of diplopia : base-out prisms, botulinum toxin injection
of the medial rectus muscles, strabismus surgery.
Surgical treatment
Pseudodivergence excess exotropia symmetric recession of
both lateral rectus muscle
Basic intermittent exotropia combined lateral rectus m.
Recession and medial rectus m. Resection
Smaller exodeviations unilateral lateral rectus m. recession
Convergence Weakness
Exotropia
There are 2 main types of convergence weakness exotropia:
convergence insufficiency (CI), in which there is usually no
distance deviation
convergence weakness associated with exotropia at both
distance and near fixation, but greater at near.
Constant Exotropia