Three common nonsurgical management strategies for childhood intermittent exotropia are observation alone, part-time patching, and over-minus spectacles. Each of these approaches has support from recent large observational studies and recent randomized clinical trials. The deterioration rate with observation alone is particularly low, over both a 6-month and 2-year period, suggesting that observation alone is a very reasonable option. Future studies on the natural history of childhood intermittent exotropia are forthcoming and a larger randomized clinical trial of over-minus spectacles versus non-over-minus spectacles is planned.
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