BT for intermittent exotropia
Reviewed by Fiona Rowe

This study aimed to evaluate the effect of botulinum toxin (BT) on the amount of deviation and fusional control state of intermittent exotropia. Twenty-one patients (five male and 16 female) aged five to 18 years with progression of exotropia were recruited. Each had reduced fusional control and an increased Newcastle control score (≥3). BT of 10 units Dysport was given to the lateral rectus muscles. A minimum follow-up of six months was allowed. The Newcastle control score increased significantly over follow-up. Stereoacuity improved from 224.6 ±278.9” pre-treatment to 100 ±100.3” post treatment. The near angle of deviation reduced from 26.4 ±10.1 to 1.8 ±10.3PD and the distance angle of deviation reduced from 30.9 ±7.1 to 11.8 ±14.4PD. Binocular alignment within 10PD was achieved by 38.1% at distance fixation. Mild ptosis was documented in nine patients (42.8%). The authors propose this to be a promising treatment. 

Efficacy of botulinum toxin in the treatment of intermittent exotropia.
Etezad Razavi M, Sharifi M, Armanfar F.
STRABISMUS
2014;22:176-81.