Overminus lens therapy in the management of intermittent exotropia in children

Background Intermittent exotropia is characterized by an exophoric deviation that is intermittently compensated by fusional convergence, but occasionally decompensates into a manifest exotropia. Aim This investigation aimed to evaluate the clinical outcomes of overminus lens therapy in the treatment of pediatric patients diagnosed with X (T). Patients and methods This prospective research included 20 children under the age of six, of both sexes, diagnosed with X (T) exhibiting well to moderate control. All patients underwent a comprehensive ophthalmologic evaluation, including refraction assessment, monocular visual acuity testing, ocular motility and alignment examinations, and measurement of the angle of deviation, fundus examination, and evaluation of exodeviation control. Results No notable difference was observed among the spherical equivalents of the right and left eyes. A slight, yet statistically insignificant, myopic shift was noted at the 6-month follow-up; however, refractive changes were not monitored following the discontinuation of glasses. A highly significant decrease in the angle of deviation was observed ( P <0.001), as well as a marked improvement in control of the deviation throughout the study period ( P <0.001). Treatment success was achieved in 17 out of 20 (85%) patients, while three (15%) patients did not respond successfully. Additionally, three (10%) patients experienced asthenopia, whereas the remaining 18 (90%) patients did not report any asthenopic symptoms. Conclusions Overminus lens therapy represents an effective noninvasive intervention for the control of intermittent exotropia in pediatric patients. The use of overminus lenses consistently reduces the angle of deviation and enhances management of distance exotropia, as assessed by Newcastle Control Score.