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. 2010 Mar;149(3):503-7.
doi: 10.1016/j.ajo.2009.10.009.

The development of myopia among children with intermittent exotropia

Noha S Ekdawi  1 , Kevin J Nusz, Nancy N Diehl, Brian G Mohney
Affiliations

The development of myopia among children with intermittent exotropia

Noha S Ekdawi et al. Am J Ophthalmol. 2010 Mar.

Abstract

Purpose: To describe the long-term refractive error changes in children diagnosed with intermittent exotropia (IXT) in a defined population.

Design: Retrospective, population-based observational study.

Methods: Using the resources of the Rochester Epidemiology Project, the medical records of all children (<19 years) diagnosed with IXT as residents of Olmsted County, Minnesota, from January 1, 1975 through December 31, 1994 were retrospectively reviewed for any change in refractive error over time.

Results: One hundred eighty-four children were diagnosed with IXT during the 20-year study period; 135 (73.4%) had 2 or more refractions separated by a mean of 10 years (range, 1-27 years). The Kaplan-Meier rate of developing myopia in this population was 7.4% by 5 years of age, 46.5% by 10 years, and 91.1% by 20 years. There were 106 patients with 2 or more refractions separated by at least 1 year through 21 years of age, of which 43 underwent surgery and 63 were observed. The annual overall progression was -0.26 diopters (SD +/- 0.24) without a statistically significant difference between the observed and surgical groups (P = .59).

Conclusion: In this population-based study of children with intermittent exotropia, myopia was calculated to occur in more than 90% of patients by 20 years of age. Observation versus surgical correction did not alter the refractive outcome.

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Figures

FIGURE 1
FIGURE 1
Initial refractive error by age in 135 children with intermittent exotropia.
FIGURE 2
FIGURE 2
Kaplan-Meier estimate of myopic progression by age (with 95% CI) in 135 children with intermittent exotropia.
FIGURE 3
FIGURE 3
The Kaplan-Meier rate of myopic progression between 54 IXT patients who underwent surgery and 81 who were observed (P = .16).
FIGURE 4
FIGURE 4
A comparison of the prevalence of myopia by age from this study with published reports of normal populations from the United States.
See this image and copyright information in PMC

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