The aim of this study was to evaluate clinical preoperative symptoms and changes to these postoperatively in patients with exotropia. A non-validated questionnaire with 15 questions was used: three subscales including stereopsis (five questions), ocular fatigue (five questions) and cosmetic symptoms (five questions). This was rated on a five-point score of 0 (no symptoms) to 4 (extreme symptoms). Fifty patients were recruited: 32 intermittent exotropia and 18 constant exotropia. Mean age was 10.6 ±7.75 years. Preoperative distant angle was 26.9±7.79PD and for near was 27.64±8.29PD. For intermittent exotropia, symptoms of squint and out of focus associated with appearance gave high scores with significant improvement postoperatively. The third highest score was for headache which decreased postoperatively. For constant exotropia, high scores were squint, out of focus and difficulty making eye contact – all were associated with appearance. All improved significantly postoperatively. Other symptoms also improved significantly postoperatively including tripping, collisions, headache, eye fatigue, squint and out of focus. Of 18 patients, nine had exotropia greater than 30PD and nine less than 30PD. Generally, no difference was found in relation to angle magnitude. There was no significant difference for stereopsis questions or asthenopia questions for intermittent versus constant exotropia. Symptoms did differ for age: asthenopia related symptoms scored higher in older ages. The authors acknowledge limitations with regard to small sample size, subjective nature of questions and inclusion of exotropia.