Improving distance stereopsis in intermittent exotropia with training
Reviewed by Fiona Rowe

This study compared the control ability of patients with stereopsis and analysed the influencing factors of the improvement of distance stereopsis in children with intermittent exotropia. Seventy-eight children were recruited: 33 male, 45 female with mean age of 8.4 ±2.72 years. Newcastle control scores (NCS) were used to divide children into two groups: low NCS ≤3 and high NCS >4. Patients were included with angles of 15-30PD and with assessment cooperation and maintained follow-up. Near stereopsis was present in 33 and 22 had distance stereopsis at baseline assessment. Training was provided consisting of lens sequencing to increase accommodative amplitude, flipper training to improve adjustment sensitivity, polarised stereogram and cheiroscope training to improve convergence and fusion. This was done twice per week over three months. There was a significant training effect from pre to post training for the low NCS group with improved stereopsis. Stereopsis improved for the high NCS group but not significantly. Age at onset, near point of convergence and NCS were important factors affecting recovery of distance stereopsis. Gender, education, angle and refractive error had no significant effect. Limitations of the study include limited multi-factor analysis and being unable to consider different types of exotropia. A longer follow-up would also be desirable. The authors suggest further large-scale studies are warranted to evaluate long-term effects of improving distance stereopsis on control of intermittent exotropia.

Effect of the control ability on stereopsis recovery of intermittent exotropia in children.
Tang W, He B, Luo J, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2021;58:350-4.