الفهرس 
Aim of the workOnly 14 pages are availabe for public view
 |  | from | 74 |  |  |
| | | from | 74 | | |
Abstract
Intermittent distance exotropia X(T) is a form of early onset
childhood strabismus, affecting around 32 per 100,000 of children
aged under 19 years. It comprises periodic divergent misalignment
which is initially present on distance fixation, or during periods of
tiredness or inattention alone, but may become more frequent and be
present on near fixation, eventually leading to constant exotropia in
some cases. Constant exotropia following de-compensation of
intermittent to constant exotropia causes loss of near stereopsis, with
suppression or panoramic vision and amblyopia, or diplopia,
depending on age of onset.
Despite the incidence of amblyopia in cases of X (T) is
uncommon, amblyopia treatment may improve the control of the
squint. Treatment of amblyopia consists of correcting the optical
deficit (wearing the necessary spectacle prescription) and often
forcing use of the amblyopic eye, by patching the good eye. Current
clinical guidelines based on expert opinion advise the initiation of
amblyopia treatment before surgical correction of strabismus.
Correction of the underlying refractive error is the initial step
towards management of X(T). Providing clear retinal images may
promote fusion and lead to a reduction or elimination of the deviation
in some cases. Part time patching has found some use in very young
children. It is a passive anti-suppression technique as opposed to the
active techniques involving diplopia awareness. Part time patching of
the non-deviating eye for four to six hours daily may convert an
intermittent exotropia to a phoria. Although the benefit is usually
Summary
55
temporary, occlusion can be used to postpone surgical intervention in
responsive patients.
Our study included 50 children of both genders diagnosed with
amblyopia and X (T) who divided into 3 groups: group (A): 20
patients who have bilateral amblyopia have been given spectacles.
group B: 13 patients who have insignificant refractive errors have
been given part time patching therapy .group C:17 patients who have
unilateral amblyopia with significant refractive errors have been given
spectacles and part time patching therapy. The mean age of the studied
children 6.32 years. 50% were males and 50% were females. 19(38%)
children had basic extropia, 14(28%) had pseudo extropia and
17(34.0) had true extropia. Visual acuity improved after treatment in
45(90%) of the studied children. from the improved cases, near and
far angle of strabismus were insignificantly improved after 3 and 6
months of treatment but the office control and stereopsis were
significantly improved after 3 and 6 months of treatment.