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 above place occluder over right eye for 10 seconds then observe for 10 seconds, 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 with near fixation.
3. Record the worst level of control noted
4. This test should be done before any dissociation or patching or at least 10 minutes after any dissociation.

This scale is applied to each patient for both distance and near fixation which, when combined, yields an overall control score ranging from 0 to 10. Levels 5 to 3 are assessed during an initial 30-second period of observation. Levels 2 to 0 are graded as the worst of three rapidly successive trials. An occluder is placed over the right eye for 10 seconds and then removed, measuring the length of time it takes for fusion to become re-established. The left eye is then occluded for a 10-second period and the time to re-fusion is similarly measured. A third trial of 10-second occlusion is performed, covering the eye that required the longest time to re-fuse. The worse level of control observed following the 3, 10-second periods of occlusion should be recorded for that visit. 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.