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Neurological exotropia: do we need to decrease surgical dosing?
  1. Genie M Bang,
  2. Michael C Brodsky
  1. From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Professor Michael C Brodsky, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA; Brodsky.michael{at}

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Children with neurological disorders have a high prevalence of horizontal strabismus.1 Although esotropia predominates,1 exotropia is considered to be highly suggestive of neurological disease.2 Strabismic children with neurological impairment have poorer surgical outcomes, possibly due to variability of measurements and decreased fusional capacity.3 ,4 Nevertheless, they can benefit functionally and cosmetically from successful surgical correction.3 ,4

It has been noted that children with neurological esotropia are prone to surgical overcorrection.3 ,5 Consequently, strabismus surgeons often decrease surgical dosing in these children. It is unknown whether this same practice is advisable with neurological exotropia. This report describes our surgical results in nine patients with neurological exotropia who were treated with bilateral lateral rectus recessions.

Subjects and methods

A retrospective chart review of strabismic patients examined by one of the authors (MCB) from 2008 through 2011 was performed. This chart review was approved by the Institutional Review …

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  • Contributors Both authors participated in the conception and design, acquisition of data, analysis and interpretation of data. We both drafted the article and have given final approval to the submitted version of the paper.

  • Funding This work was supported by an unrestricted grant to the Department of Ophthalmology from Research to Prevent Blindness, New York and Mayo Foundation, Rochester, MN.

  • Competing interests None.

  • Ethics approval Ethics approval provided by the Mayo Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.