How do you approach the timing of surgical intervention in intermittent exotropia?  

If the child alternates fairly well and there is no amblyopia, I monitor the strabismus every six months. There is no urgency to operate in these cases, and multiple measurements of the angle over time are beneficial. The frequency helps with the decision. If the eyes are exotropic more than 40% of ...

Intermittent exotropia is typically a deteriorating condition due to deterioration of distance fusion. In order to follow binocular function at distance in these children, I relied on the distance vectograph. By the time they are exotropic for any significant percentage of time, binocularity has alr...

I trained with Ken Wright, and his rule of thumb was to try to wait until after four years old, the thinking being that the binocularity is pretty much matured and they will appreciate diplopia, thus stimulating them to pursue single vision. Generally, if you operate and get the desired small overco...