Journal of Ophthalmology

Journal of Ophthalmology / 2016 / Article

Comment on “Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review”

  • Onder Ayyildiz | Osman Melih Ceylan | Fatih Mehmet Mutlu |
  •  Article ID 8251629 |
  •  Published 25 Jul 2016

Response to: Comment on “Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review”

  • Xinping Yu | Zhouduo Ji | ... | Jinling Xu |
  •  Article ID 7402715 |
  •  Published 16 Mar 2017
  • | View Article

Letter to the Editor | Open Access

Volume 2016 |Article ID 8251629 | 1 page |

Comment on “Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review”

Academic Editor: Lisa Toto
Received28 Mar 2016
Accepted29 Jun 2016
Published25 Jul 2016

We congratulate Yu et al. for their successful results where they evaluated the pattern distribution and the changes of strabismus surgery in pediatric population [1]. The authors observed that surgery for childhood exotropia was more common than surgery for esotropia in China and they stated that strabismus type and onset age were found to be associated with binocular function for subjects with older onset age and intermittent exotropia.

Intermittent exotropia (X(T)) is the most common form of childhood exotropia [2]. It has various nonsurgical treatment options such as patching, orthoptic therapy, and over-minus lenses; however, surgical treatment is the major curative option [3]. The type of X(T) and the timing of surgery for pediatric patients are important because of the risk of developing a suppression scotoma and monofixation esotropia, which can lead to loss of stereopsis and amblyopia [4]. In the present study, the authors did not mention strabismus subtypes; it would be better to establish the strabismus subtypes per age groups. We also kindly ask what inclusion and exclusion criteria were followed to decide surgery for both exotropia and esotropia. We noticed that the authors evaluated only near stereopsis with Titmus test. It was believed that distance stereoacuity and control of strabismus are more objective to decide the timing of surgery [5]. We kindly suggest that the authors evaluate the changes in binocular visual function in patients with X(T) of different ages preoperatively and postoperatively.

Competing Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.


  1. X. Yu, Z. Ji, H. Yu, M. Xu, and J. Xu, “Exotropia is the main pattern of childhood strabismus surgery in the South of China: a six-year clinical review,” Journal of Ophthalmology, vol. 2016, Article ID 1489537, 5 pages, 2016. View at: Publisher Site | Google Scholar
  2. B. G. Mohney and R. K. Huffaker, “Common forms of childhood exotropia,” Ophthalmology, vol. 110, no. 11, pp. 2093–2096, 2003. View at: Publisher Site | Google Scholar
  3. J. Y. Lee, S. J. Ko, and S. U. Baek, “Survival analysis following early surgical success in intermittent exotropia surgery,” International Journal of Ophthalmology, vol. 7, no. 3, pp. 528–533, 2014. View at: Publisher Site | Google Scholar
  4. P. M. Edelman, M. H. Brown, A. L. Murphree, and K. W. Wright, “Consecutive esodeviation: then what?” American Orthoptic Journal, vol. 38, pp. 111–116, 1988. View at: Google Scholar
  5. X. Feng, X. Zhang, and Y. Jia, “Improvement in fusion and stereopsis following surgery for intermittent exotropia,” Journal of Pediatric Ophthalmology and Strabismus, vol. 52, no. 1, pp. 52–57, 2015. View at: Publisher Site | Google Scholar

Copyright © 2016 Onder Ayyildiz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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