Main Article Content
Abstract
Constant exotropia, defined by persistent outward deviation of the eye, can cause cosmetic concerns and disrupt binocular function if untreated. We report a case of a 26-year-old male with long-standing left-eye exotropia and amblyopia since early childhood. Preoperative assessment revealed a visual acuity of 6/30 in the left eye, 15° exotropia on Hirschberg testing, 30 prism diopters on prism alternate cover testing, alternating fixation with right-eye dominance, and left-eye suppression on the Worth Four Dot test. The patient underwent unilateral lateral rectus recession and medial rectus resection. One week postoperatively, ocular alignment was orthotropic with satisfactory cosmetic and motor outcomes, while functional binocular vision remained limited. This case demonstrates the effectiveness of surgical intervention in restoring alignment and appearance in adult sensory exotropia and emphasizes the importance of early detection and timely management to prevent irreversible sensory deficits.
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Copyright (c) 2026 Eva Imelda, Cut Salsabila Mahfiza, Eka Fadliyani, Nikhil Toshnowal

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
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- Kyle B, Gerhard C, Marco Z, Gulani AC. Amblyopia. StatPearls Publishing 2024.
- Harris J, Garratt S. Esotropia and Exotropia Preferred Practice Pattern ® 2018.
- Jung EH. Surgical Results and Factors Affecting Outcome in Adult Patients with Sensory Exotropia. Eye 2018:1851–7. https://doi.org/10.1038/s41433-018-0189-x.
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References
Cantor LB, Rapuano CJ, Cioffi GA. Pediatric Ophthalmology and Strabismus. Section 6. Basic Clin. Sci. Course, American Academy of Ophtalmology; 2018, p. 65–70.
Huang S, Zhong X, Quan C, Zhang M. Non-Surgical Treatment of Strabismus in Children : A Review of Recent Advances 2025:1–7. https://doi.org/10.3389/fmed.2025.1582284.
Kanukollu VM, Sood G. 2023. Strabismus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. n.d.
Putri P. Profil Strabismus Horizontal Di RSUP Dr . M Djamil Padang Januari – Desember 2017 2017;9:83–8.
Qanat AS, Alsuheili A, Alzahrani A, Faydhi AA, Alhibshi N. Assessment of Different Types of Strabismus Among Pediatric Patients in a Tertiary Hospital in Jeddah 2020;12:1–7. https://doi.org/10.7759/cureus.11978.
Chougule P, Kekunnaya R. Surgical Management of Intermittent Exotropia : Do We Have an Answer for All ? 2019. https://doi.org/10.1136/bmjophth-2018-000243.
Wright KW. Pediatric Ophthalmology Pediatric Ophthalmology. n.d.
Kaur S, Shipra S, Aggarwal H, Dadeya S. Comprehensive Review of Amblyopia : Types and Management. Indian Journal of Ophthalmology 2023;71. https://doi.org/10.4103/IJO.IJO.
Martinez SM, Mary W. Genetics of Strabismus. Front Ophthalmol 2023.
Martinez M, Whitman MC. Genetics of Strabismus. FrrontOphtalmol 2023. https://doi.org/10.3389/fopht.2023.1233866.
Kyle B, Gerhard C, Marco Z, Gulani AC. Amblyopia. StatPearls Publishing 2024.
Harris J, Garratt S. Esotropia and Exotropia Preferred Practice Pattern ® 2018.
Jung EH. Surgical Results and Factors Affecting Outcome in Adult Patients with Sensory Exotropia. Eye 2018:1851–7. https://doi.org/10.1038/s41433-018-0189-x.
Monte ADM, Archer SM. Atlas of Pediatric Ophthalmology and Strabismus Surgery. American Academy of Ophtalmology; 2022.