Historical perspective of surgical approaches to intermittent exotropia

Introduction and Purpose: To outline the progression of thinking about intermittent exotropia and its surgery. Patients and Methods: Review of publications over a period of approximately 200 years. Results: Revision of the concept that the cause of intermittent exotropia is excessive divergence to one recognizing that intermittent exotropia is a position of rest modifi ed by convergence. Advances in technology have contributed to surgical approaches, especially for reoperations. Conclusion: Most of our presently employed surgical procedures for intermittent exotropia are revivals rather than new, and have been adapted for deviations formerly considered too small for operation.