Understanding Exotropia: Causes, Symptoms, and Treatment Options

Exotropia is a form of strabismus (eye misalignment) characterised by the outward turning of one or both eyes. Also known as “divergent strabismus,” this condition presents unique challenges.

In this blog post, we will delve into the causes, symptoms, and treatment options for exotropia, emphasising the importance of understanding and addressing this eye misalignment.

Causes of Exotropia

  1. Intermittent distance exotropia: This is a common condition that develops in childhood, with a divergent strabismus usually observed when the child focuses on something far away, or when in sunlight.

  2. Muscle Imbalance: Similar to esotropia, exotropia often results from an imbalance in the muscles responsible for eye movement. Weaker muscles that control inward eye movement can lead to the eyes drifting outward.

  3. Neurological Factors: Certain neurological conditions, such as cranial nerve palsies or brain injuries, can disrupt the coordination of eye movements and contribute to exotropia.

  4. Genetic Predisposition: Like esotropia, exotropia can have a genetic component, and individuals with a family history of strabismus may be more susceptible to developing this condition.

Symptoms of Exotropia

  1. Outward Eye Deviation: The primary symptom of exotropia is the outward turning of one or both eyes, creating a divergent appearance. The misalignment may be constant or intermittent.

  2. Double Vision: Exotropia can lead to double vision, where the brain receives conflicting signals from the misaligned eyes. The brain may suppress the image from one eye to alleviate visual confusion.

  3. Difficulty with Depth Perception: Individuals with exotropia may experience challenges in judging depth and spatial relationships, affecting activities that require accurate depth perception.

  4. Eye Fatigue and Headaches: Straining to align the eyes can result in eye fatigue and headaches, especially during activities that demand prolonged visual focus.

Treatment Options

  1. Glasses or Contact Lenses: Correcting refractive errors with prescription glasses or contact lenses can help manage exotropia associated with farsightedness or astigmatism.

  2. Eye exercises: Eye exercises are aimed at improving eye coordination, strengthening muscles, and enhancing binocular vision. This approach may be beneficial for managing some forms of exotropia.

  3. Prism Lenses: Prism lenses can be prescribed to help redirect light entering the eyes, reducing symptoms of double vision in selected cases.

  4. Eye muscle (strabismus) Surgery: Strabismus Surgery may be recommended to adjust the eye muscles and correct the misalignment, especially in cases where other treatments prove insufficient.


Exotropia may pose challenges, but with early intervention and personalised care, it can be a treatable condition. At Clarity Eye Surgeons, under the expertise of Dr Parth Shah, we specialise in advanced treatments tailored to your unique needs. Whether or not it involves eye muscle surgery, our focus is on enhancing your eye health and quality of life.

Don’t let exotropia impact your vision. Contact us today for the first step towards a clearer and more comfortable future.

Author Bio

Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra, specialising in cataract surgery and strabismus surgery. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.

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