In X-pattern strabismus, an exodeviation is present in primary position and increases in both upgaze and downgaze. This pattern is usually associated with overelevation and overdepression in adduction when the eye moves slightly above or below direct side gaze. X patterns are most commonly seen in patients with large-angle exotropia.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.