Intermittent Exotropia Office Control Score

Adapted from Mohoney BG. Holmes JM. An office-based scale for assessing control in intermittent exotropia. Strabismus 2006;14:147-150

  1. Observe the child:
    • for 30 seconds when fixating at distance object
    • if exotropia noted score will be 5, 4 or 3.
    • Repeat observation with near fixation target for 30 seconds.
  2. If no deviation noted after observation:
    • Place occluder over right eye for 10 seconds then observe for exotropia counting the seconds until recovery, repeat by occluding the left eye with distance fixation.
    • Occlude for another 10 seconds the eye that took the longest to re-fuse and then observe.
    • Repeat the occlusion process with near fixation.
  3. Record the worst level of control noted for distance and near fixation
  4. This test should be done before any dissociation or patching or at least 10 minutes after any dissociation.
  5. If the patient has a micro-esotropia by simultaneous prism and cover test, but exodeviation by alternate cover test, the scale applies to the exodeviation.
Scale Score Description
5 Constant Exotropia
4 Exotropia >50% of the 30 second observation
3 Exotropia <50% of the 30 second observation
2 No Exotropia unless dissociated and recovers > 5 seconds
1 No Exotropia unless dissociated, recovers in 1-5 seconds
0 No Exotropia unless dissociated, recovers in < 1 second (phoria)