Intermittent exophoria is NOT a clinical diagnosis. Intermittent exotrophia is the correct term. It is not an eye muscle problem but rather a result of abnormal vision fusion in the brain. Now esophoria is very common and often asymptomatic. I am an eye surgeon but I have a small to medium exophoria. It turns into an exotrophia rarely if I am extremely fatigued.
Eye exercises as used by many optometrists as a profit center have not been show to be helpful except for convergence insufficiency. Intermittent exotrophia often requires no treatment, if it degenerates to the point that they eyes are out more than straight then strabisums surgery is usally the answer.
Hi Dr. Hagan,
That's what I was curious about was convergence insufficiency. Very frequently I can see my vision go double while focusing on near objects particularly if I'm tired. It's actually happening right now.. I'll be focusing on the screen or something or the keyboard when I'm typing and then my vision will go double where I see two of everything. I then have to bring the two images back into fusion. The question I had was that I think this is causing more eye aching for me considering my eyes would have to work harder to keep them turned inward if they prefer to be positioned oiutward all the time. Is there anything you can recommend to help this?
I had mild exophoria. The problem sounds not serious will not cause me can't see things. However, it just make my eyes feel tired/pain after reading for 1/2 hr. This really a big impact to my life - Low productivity in work, no entertainment like reading magazine, watching TV.
I heard that some lens with prism power can help to correct this problem. How mature is this technology ? How realistic this kind of lens can solve the exophoria.
As Dr. Hagan states (above), a phoria is a result of abnormal fusion in the brain, and it is very common and often asymptomatic. However, even a mild phoria can create significant problems with fusion when you add mild retinal damage (making the images in each eye slightly different in size/shape) and differences in refractive error between the eyes (creating a difference in image size). Dr. Oyakawa has suggested that you try wearing a contact lens to eliminate the 2+ diopter difference between your eyes due to the buckle. This should make it easier for your brain to fuse the images from each eye, and it might reduce/eliminate some of your symptoms.
We are very fortunate that JodieJ continues to share her experience and research with our posters.
Is there a cure for exophoria? My daughter is having Vision therapy about once a week for the past 3 months, and I do not notice a difference. Am I wasting my money?
In almost all cases you are wasting your money. Vision therapy is a profit center for non-MD optometrists and they ride it for all its worth.
There are no scientific studies that show the vision therapy is useful for anything other than optometrists paying their bills.
I have an exophoria, most do not require any sort of therapy.
Hi Dr. Hagan,
I was recently diagnosed with exophoria of 20 diopters at near and 6 at distance (snellen chart). Are you saying vision therapy can't help this condition at all? I have moderate to severe symptoms of eye strain.
I am saying That it would likely be much less expensive to consult a strabismus (pediatric) ophthalologist. If you live in the USA find one near you at www.aao.org
Re-read the entire discussion thread. It stands on its own.
I had an occasional squint from a young age, and had it diagnosed recently, at 24 years of age. I am diagnosed with alternating exophoria. Orthoptic tests also revealed convergence insufficiency and lack of stereopsis. A few days of vision therapy where I had to fuse left and right images brought back stereopsis to some extent. Occasional squint continues, but the tendency to completely ignore one eye is now gone. I may have to visit a squint specialist soon, according to the orthoptist.
Is vision therapy useless for me too? Any non surgical options?
If you are seeing an orthoptist you are doing all you can with "vision therapy". In adults the success is very limited. If the condition worsens seeing a strabismus eye MD would make sense.