Among 83 patients who had undergone the operation for intermittent exotropia, 15 patients had esotropia persisting longer than one month after the ope

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1 Among 83 patients who had undergone the operation for intermittent exotropia, 15 patients had esotropia persisting longer than one month after the operation. We followed up these 15 patients and analyzed them with reference to a relationship between pre-operative and post-operative orthoptics. Management of consecutive esotropia was also mentioned. The results were as follows. 1) Eleven out of 15 patients had pre-operatively constant exotropia at distance, of whom 8 patients showed Worth's grade 0 with synoptophore, and 9 were combined with small hyperphoria. Constant esotropia at both distant and near eye position occured among the patients who had gross stereopsis at near vision, hyperphoria, and/or a high AC/A. 2) It is suggested that the patients who had poor binocular function, hyperphoric deviation or a high AC/A, appear to be apt to be overcorrected by the intermittent exotropia operation. 3) Six months after the operation the eye alignment shifted to intermittent esotropia or exophoria in 11 patients. However, 4 patients still remained esotropic. They were applied for prismatic therapy. 4) Four patients who postoperatively showed constant esotropia had had small hyperphoria before the operation. Hyperphoric deviation became hypertropic and amount of deviation evidently increased in three patients after the operation. Two of them were required surgery to correct hypertropia after esotropia was treated by prismatic therapy. 5) The effects of prismatic therapy which was applied for 4 patients were remarkable. The therapy was even effective against 2 patients who started wearing the prism more than 6 months after the operation, although it is generally accepted that prismatic therapy is effective within 6 months after the operation. Key Words: consecutive surgical exotropia intermittent prismatic therapy exotropia

9 3) Cooper, E.: Purposeful overcorrection in exotropia. Strab. Symp. in Giessen, August 9-12, ) Burian and Spivey.: Cited by Duke Elder, S.: Concomitant strabismus., System of Ophthalmology, vol.vi, , C.V. Mosby, St. Louis., ) Dunlap, E.: Overcorrections in exotropia in surgery, Strabismus, Symp. Giessen, August 1966,: , ) Hardesty, H.: Tteatment of overcorrected intermittent exotropia., Am. J. Ophth. 66: 80-86, ) Rabb, E. and Parks, M.: Recession of the lateral recti. Arch. Ophth. 82: , ) Hardesty, H.: Prism in the management of intermittent exotropia. Am. Orthop. J. 22: 22-30, ) von Noorden, G.: Exodeviations., Binocular vision and ocular motility., 2 ed.: , C. V. Mosby, ) Hardesty, H.: Boynton, J. and Keenan, J.: Treatment of intermittent exotropia., Arch Ophth. 96: , ) Moore, S.: Stockbridge and Knapp, P.: A 1) Jampolsky, A.: Surgical management of exotropia. Am. J. Ophth. 46: , ) Knapp, p. and Moore, S.: Intermittent exotropia. Am. Orthop. J. 10: , panoramic view of exotropias. Am. Orthop. J. 27: 70-79,

Therapy for Asthenopia in Cases of Convergence Insufficiency Hiroko TAKASAKI, C.O.J., Nobuko INAGAMI, C.O.J., and Kayoko TAKENAWA, C.O.J.. Orthoptic c

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