Esotropia or exotropia may develop as a result of any condition that severely reduces vision or the visual field in 1 eye. It is not known why some individuals become esotropic and others exotropic after unilateral vision loss. In addition, although both sensory esotropia and sensory exotropia occur in infants and young children, the latter predominates in older children and adults. If the vision in the exotropic eye can be improved, peripheral fusion may be reestablished after surgical realignment, provided the sensory exotropia has not been present for an extended period. Loss of fusional abilities, known as central fusion disruption, can lead to constant and permanent diplopia despite anatomical realignment when adult-onset sensory exotropia has been present for several years before vision rehabilitation.
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.