Robert P Rutstein, David A Corliss

The clinical course of intermittent exotropia

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Purpose: To report the clinical course for patients with intermittent exotropia.

Methods: The clinical records of patients diagnosed with intermittent exotropia from 1983 to 1991 who had at least 4 years of follow-up were reviewed. All patients with neurological or medical abnormalities, developmental delays, ocular disease, or having strabismus surgery during the follow-up period were excluded.


Results: Of the 468 records reviewed, 73 met the inclusion criteria. Forty-four patients were female, and 29 were male. Fifty-two patients had basic intermittent exotropia, 11 patients had divergence excess intermittent exotropia, and 10 patients had convergence insufficiency intermittent exotropia. The mean age at initial visit was 20 years (range, 1 to 63 years). The mean follow-up was 10 years (range, 4 to 23 years). Four patients had amblyopia of 20/30 or worse, nine patients had a vertical deviation in the primary position, and 10 patients had undergone extraocular muscle surgery before coming to our clinic. Sixty patients received some form of treatment during follow-up. The mean stereoacuity at the initial and final visits were 59 and 70 s arc, respectively. The initial mean spherical equivalent refraction was -0.48 D and increased to -1.15 D at the end of the study. The mean exodeviation changed from 17.2 Delta at distance and 17.6 Delta at near at the initial visit to 13.7 Delta at distance and 13.5 Delta at near at the final visit. At the initial visit, 63 patients were exotropic and 10 patients were either heterophoric or orthophoric at distance, whereas, 60 patients were exotropic and 13 patients were either heterophoric or orthophoric at near. At the final visit, 37 patients were exotropic and 36 patients were either heterophoric or orthophoric at distance whereas 33 patients were exotropic and 39 were either heterophoric or orthophoric at near. One patient was esotropic at near at the last visit. Changes in the size and quality of the exodeviation, although statistically significant (p < 0.001), were not associated with any specific treatment regimen or with longer periods of follow-up. Measurements exhibited a regression toward the mean.

Conclusions: Intermittent exotropia improved for many patients quantitatively and qualitatively over time. That the improvement was unrelated to any treatment and length of follow-up suggests that the changes at least quantitatively are not associated with any physiologic process and may be due, in part, to regression toward the mean.


I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional.  Manny helped me to pick out frames and explain my coverage.  Very helpful and patient not like the individual at the other place I rated here on Yelp.  I was running late and he still helped me and was not bothered at all.  I am so glad I came here ..........very pleased.

Very professional staff and pleasant.

Daniel G.
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