J Korean Ophthalmol Soc.  2017 Aug;58(8):1012-1015. 10.3341/jkos.2017.58.8.1012.

A Case of Cyclic Exotropia in a Pediatric Patient

• Choi H
• Ha SG
• Kim SH

• KMID: 2388194
• DOI: http://doi.org/10.3341/jkos.2017.58.8.1012

Abstract

PURPOSE
To report a case of cyclic exotropia in a pediatric patient.
CASE SUMMARY
There was a pediatric exotropia patient with large variation of prism diopter on alternate cover test at each visits. Not large enough for going through the surgery, she was recommended for the regular check-ups. Sometimes, she was orthophoria and some other times, distinct exotropia. After a few times of follow up, she showed 25-prism diopter exotropia on alternate cover test. The surgery was scheduled and she was admitted after 2 weeks. At the preoperative evaluation, she was orthophoria. She was discharged without having the surgery. To evaluate daily eyeball deviation status, the parents were asked to write a daily note on patient's eye condition. For 3-months, daily strabismus note was thoroughly reviewed and alternate cover test was performed monthly. Patch test was performed twice, and results were 10 and 12 prism diopter exotropia, each. Analyzing the note, a cycle of being the orthophoria and exotropia was noted. With the cycle of 72-hours, she was diagnosed with cyclic exotropia and the surgery was re-scheduled. Ulnilateral lateral rectus recession was performed. Without undercorrection or recurrence, she has been stayed stable over two years of follow up period.

Keyword

Cyclic exotropia; Intermittent exotropia; Orthophoria; Strabismus note

MeSH Terms

Exotropia*
Follow-Up Studies
Humans
Parents
Patch Tests
Recurrence
Strabismus

Figure

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  Figure 1 The patient with 25 prism diopter exotropia. This is when the surgery was first scheduled.

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  Figure 2 The orthphoric patient. This is when patient was admitted for the surgery. The surgery was hold since she was orthophoric in alternative cover test.

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  Figure 3 Orthophoric patient 1 week after the surgery. She was diagnosed with 72 hour cycle exotropia and unilateral lateral rectus recession was performed.

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  Figure 4 Strabismus note. Daily note regarding the presence of eyeball deviation by the patient's mother.

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