Improving Control of Alignment in Intermittent Exotropia
BACKGROUND: Currently, less than 30% of children have good long-term outcomes following treatment for intermittent exotropia (IXT). . Although poor binocular sensory status (suppression and stereoacuity) is thought to be the major factor in poor treatment outcomes, there have been no prospective studies or randomized clinical trials of sensory fusion training GAP: The low rate of treatment success for IXT is most likely due to poor sensory status; there is a need for a sensory intervention that can reduce suppression and support stereoacuity. HYPOTHESIS: Sensory training to decrease suppression and engage stereoacuity may improve control of alignment in children with IXT and moderate to poor control alignment. METHODS: Study design: Two parallel randomized controlled trials: randomization to 4 weeks of 3D movies or 2D (sham) movies in a 1:1 ratio beginning immediately after enrollment/baseline testing (Aim 1) or starting 6 weeks post-op (Aim 2); research staff, pediatric ophthalmologist, and families will be masked. Study population: Eligible children with IXT, ages 4-10 years, with normal visual acuity, moderate to poor control of ocular alignment, ocular misalignment >10 pd at distance and near, Basic IXT or Pseudo Divergence Excess IXT. RESULTS: Pending. IMPACT: Potential benefits of our new approach to binocular treatment for IXT include promoting binocular vision and establishing stable normal eye alignment. Normal binocular alignment not only stimulates binocular vision, but also promotes a positive self-image. The appearance of misaligned eyes impairs self-image and social interactions, and negatively affects a child and/or his or her parent’s quality of life.