intermittent strabismus
Intermittent strabismus is a manifest deviation that appears only at certain times, because fusion keeps the eyes aligned in some circumstances but not in all. The deviation breaks through when the patient wakes from a nap or is tired, ill, or under stress.1 It may also appear only in certain gaze positions or at certain target distances.2
Constant strabismus, by contrast, is present all the time and under all circumstances. Some intermittent strabismus becomes constant if left untreated, while other cases stay intermittent.3
Children with an intermittent exodeviation are often free of symptoms. A well-developed suppression mechanism eliminates their diplopia unless the deviation began recently.4 Adults with intermittent exotropia are commonly symptomatic, with the same complaints as an inadequately compensated exophoria.4
Sources (9)
- von Noorden and Campos, Binocular Vision and Ocular Motility, ch. 8
- Yanoff and Duker, Ophthalmology (2023), ch. 11.3
- Pickwell's Binocular Vision Anomalies, ch. 1
- von Noorden and Campos, Binocular Vision and Ocular Motility, ch. 17
- Caloroso, E.E., Rouse, M.W. (1993). Clinical Management of Strabismus. Butterworth-Heinemann.
- Rutstein, R., Daum, K. (1997). Anomalies of Binocular Vision: Diagnosis & Management, Mosby.
- Rowe, F.J. (2012). Clinical Orthoptics. 3rd ed., Wiley-Blackwell.
- Noorden, G.K.V., Campos, E.C. (2002). Binocular Vision and Ocular Motility: Theory and Management of Strabismus. 6th ed., Mosby.
- Scheiman, M., Wick, B. (2014). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders. 4th ed., Lippincott Williams & Wilkins.
Reviewed October 2026