Intermittent and Alternating Exophoria and Diclofenac oftalmic Drops

[lzablah]

Our 3 year old daughter has been diagnosed wtih Intermittent Exophoria, and recently wtih Alternating Exophoria as both are eyes are affected now. Prescribed treament so far has been to use Voltaren Ofthalmic Drops on alternating months, doing convergence exercises (which she can still do very well), and seeing the doctor every 3 to 4 months. She has only been dilated once with drops that the doctor put in her eyes 30 minutes before the exam (not the kind you do for 3 days prior to the visit). We live in Central America and are concerned about using the drops because we understand that the main ingredient (diclofenac) has been banned in other coutnries (at least in digestible form). We are also concerned that very little information is found on Exophoria and its treatment, except for what we see online and there we have found that many adults have had it since childhood and it was not corrected. Our doctor says she may outgrow it, that there is nothing more to do for now. We will be travelling to visit a specialist in the US this summer, to determine if there is in fact more that can be done, but in the meantime I wanted to know if these drops are indeed safe and the appropriate treament (we have seen absolutely no improvement while she has been using them, though its hard to say if she would have gotten worst without them).

Thank you kindly for any relevant information.

[mansingh77]

sir, i am serving in police and diagnosed with mild exophoria,
please specify how does this affect routine works and also upto what degree it is non-hazardous for any duties of police/military.
high regards
man singh

[John C Hagan III, MD, FACS, FAAO]

No

phoria =  eyes straight unless vision in one eye is disrupted by covering. when cover on eye removed eyes re-align

tropia= eyes are not straight any time even with both open

intermittent  exo or eso trophia  eyes are straight sometimes and not straight at other times without disruption visual image from the eye by covering.

JCH MD

[lzablah]

Thank you kindly Doctor Hagan, I will do as you suggest.

After I posted last night, I found a reply you had posted to someone else a while back, regarding the correct diagnosis of exophoria vs exotrophia. My daughter's eye movements outward are very pronounced and seem to last up to 5 or more seconds, whereas when the doctor dissassociates her eyes in his office, the movement is barely observed, and he says they move back to a normal position very quickly. In her file he notes a very slight movement, ignoring, it seems, what happens outside that controlled environment. Her teacher at pre-school and my husband and other relatives notice the same thing I do, lots of movement outward, and for what seems a long period of time, sometimes it wont stop until we ask her to close them. If she converge her eyes, could she still have intermitent exotrophia, rather exophoria?

[John C Hagan III, MD, FACS, FAAO]

You can go on the internet and also the drug's official drug RX and treatment of eye muscles problems is not an accepted use nor is it anything I have ever heard used for exophoria.

JCH MD