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Year : 1987  |  Volume : 35  |  Issue : 4  |  Page : 204-206

Exophoria and Refractive Errors- Evaluation of 250 Cases


Date of Web Publication20-Dec-2008

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N C Gupta

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PMID: 3506930

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Two hundred and fifty cases of exophoria were reviewed for the association of various refractive errors Though, myopia was the commonest association it cannot be labelled as the causative factor, because equal number of exophoria patients were emmetropic.

How to cite this article:
Gupta N C, Narang R K, Khurana A K, Parmar I, Ahluwalia B K. Exophoria and Refractive Errors- Evaluation of 250 Cases. Indian J Ophthalmol 1987;35:204-6

How to cite this URL:
Gupta N C, Narang R K, Khurana A K, Parmar I, Ahluwalia B K. Exophoria and Refractive Errors- Evaluation of 250 Cases. Indian J Ophthalmol [serial online] 1987 [cited 2022 Jan 24];35:204-6. Available from: https://www.ijo.in/text.asp?1987/35/4/204/26179

  Introduction Top

Exophoria is a condition where in the visual axes are held in parallel position under the influence of fusion and on dissociation one eye diverges [1] . Wottom [2] stated that divergence excess type exophoria is usually due to hypermetropia Mann [3] found no correlation of exophoria with refractive errors Some notes have been made in the present study on the relationship of refractive errors.

  Material and Methods Top

Two hundred and fifty cases of exophoria who attended the Orthoptic Clinic of Department of Ophthalmology were reviewed to evaluate its association with refractive errors.

  Observations Top

Incidence of exophoria was more in females (57.6%) than males (42.4%). In both sexes it was more common in young patients below30 years of age (68.8%). Out of 250 cases only 15 (6%) had disturbing symptoms Hyperphoria was associated with exophoria in 28 cases (11.2%).

  Refractive errors and Exophoria Top

Refractive error was detected in 142 (59.G%) cases of exophoria. Myopia was the commonest refractive error (45.2%) associated with exophoria followed byastigmatism (17.2%). [Figure 1] depicts the incidence of various refractive errors in exophoria As shown in [Table 2], amount of exophoria varied in different cases irrespective of the amount of refractive error. In other words no relation could be derived between the amount of refractive error and exophoria.

Out of 149 cases of exophoria associated with refractive errors, 26 (17.45%) became orthophoric and 16 (10.74%) showed partial improvement with corrective glasses A relief in symptoms with glasses occurred in 5 (33%) out of 15 sympto­matic cases.

  Discussion Top

An attempt has been made in the present review of 250 cases of exophoria to study the correlation between exophoria and ametropia. Adler [4] has suggested that presence of I to 4 prism diopters of exophoria is physiological and thus within normal limits So, only cases with exophoria of more than 4 prism diopters were included in this study.

Predilecatior of exophoria for any age and sex was analysed The overall incidence was more in females (56.6%) than males (42.4%).

Out of the 250 cases of exophoria 45.2 per cent were myopic, 40.4 per cent emmetropic, 17.2 per cent astigmatic and 14.4 per cent hypermetropic. Thus, myopia was the commonest form of ametropia associated with exophoria Dhir [7] in his study on myopic patients reported esophoria in 75 per cent cases As the number (40.4%) of emmetropic patients with exophoria is almost equal to myopic patients (45.2%), so it becomes difficult to blame myopia as the sole cause of exo­phoria Baum [8] also reported that myopia cannot be held responsible for exophoria Pascal [9] was of the view that exophoria is almost always secondary to myopia Recently Burian [10] stated that the role of myopia in the etiology of exodeviations is less pronounced than that of hypemietropia in esodeviations.

As regards the amount of exophoria and amount of ametropia, we could establish no relationship between the two. These observations are in accordance with those of Scober and Green [11]. Out of 149 cases of exophoria optically corrected only 17.45 percent became orthophoric and 10.7 per cent showed partial improvement This obervation further augments the fact that refrac­tive errors play little role in the development of exophoria. However, Marton [12] reported that majority of his cases of exophoria were relieved by the correction of refractive errors.[Table 1]

  References Top

Duke-Eider, S, 1973. System of Ophthalmology, Henry Kimpton, London, Vol VI, 537-538.  Back to cited text no. 1
Wooton, 11W., Quoted by Mann, L 1940, RJ.0., 24: 373-390.  Back to cited text no. 2
Mann, L 1940, B.J.O., 24: 373-390.  Back to cited text no. 3
Adler, F.H. 1970, Adlers Physiology of the Eye-Clinical application The CV Mosby Co.,St Louis, R 201.  Back to cited text no. 4
Gregersen, E 1969, Acta Ophthalmol, 47: 579.  Back to cited text no. 5
Krzystkowa, K and Pajakowa, J. 1972, Excerpta Medica Foundation, p. 72.  Back to cited text no. 6
Dhir, RK 1967, J. All India Ophthal Soc, 1541-53.  Back to cited text no. 7
Baum, W.W. 1942, Am. J. Ophthal 25: 291-295.  Back to cited text no. 8
Pascal, J.' 1935, Arch. OphthaL 14: 624-626.  Back to cited text no. 9
Burian, KM, Quoted by Von-Noorden, GK (1980), Binocular vision and ocular motility, The CV. Mosby, Co., St Louis, p. 288-290.  Back to cited text no. 10
Scober, RG. and Green, EL 1948, Am J. Ophthalrnol, 31 :427-41.  Back to cited text no. 11
Marton, RBB, 1941, Brit J. Physiol Opt 8: 100-102.  Back to cited text no. 12


  [Figure 1]

  [Table 1], [Table 2]


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