Correction of hyperopia in intermittent exotropia.

Therapeutic options for the management of the early phase of intermittent exotropia are limited. The correction of seemingly insignificant refractive errors might result in better control of the deviation. Patients with hyperopia present an interesting dilemma. Accommodative convergence may be used in uncorrected hyperopia to control exotropia, so it might be anticipated that correction of hyperopia will increase both the frequency and the size of the deviation. This is not always the case. We have all experienced patients with high hyperopia and intermittent exotropia that improved following optical correction. It is postulated that the improvement in visual acuity and, in some cases, the normalization of accommodation might lead to this result.