Awareness of Exodeviation in Children with Intermittent Exotropia

Purpose: To describe how children with intermittent exotropia (IXT) are aware of their exodeviation. Methods: Twenty-four children with IXT, aged 5 to 17 years, median 10.5 years, were recruited. Individual interviews with the children were audiotaped and transcribed. Interviews were based on 10 open-ended questions and discussion was encouraged. Transcripts were reviewed to identify phrases describing the child's awareness of the exodeviation as distinct from phrases describing the way intermittent exotropia affects their quality of life. Phrases were reviewed to identify specific topic areas and the type and frequency of topics were analyzed. Results: Nineteen (79%) of 24 children expressed awareness of the exodeviation. One hundred twenty phrases were extracted and 18 topic areas identified. The most frequently mentioned topics were comments from others (15 [63%] of 24), general awareness of deviation (10 [42%] of 24), ocular sensation (10 [42%] of 24), and correction of exodeviation by blinking (7 [29%] of 24). Conclusions: In our study, most patients with IXT were aware of their eye condition, but patient experience varied. In individual interviews, children described awareness of their eye condition mainly due to comments from others. Awareness of ability to correct the exodeviation by blinking was common and may be related to mechanisms used to control IXT.