Prismatic treatment combined with binocular visual training for intermittent exotropia: impact on visual function and quality of life

BACKGROUND Given the high prevalence and progressive nature of intermittent exotropia (IXT), effective interventions are urgently needed. We aimed to probe the impact of prism combined with binocular visual training (BVT) on visual function and quality of life in patients with IXT.RESEARCH DESIGN AND METHODS This was a randomized controlled trial. Eighty-six IXT patients were randomly assigned to the control group (prism only) and experimental group (prism + BVT). Outcomes included strabismus angle, fusion range, stereopsis function, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), tear film breakup time (TBUT), and refraction, quality of life [Chinese version of intermittent exotropia questionnaires (CIXTQ) scores], and visual discomfort symptoms.RESULTS After treatment, compared with the control group, the experimental group showed greater improvements in 33 cm and 6 m strabismus prism diopter, strabismus circular angle, fusion range, distant and near stereopsis detection rates, correct eye alignment, UCVA, BCVA, TBUT, and refraction (p < 0.05). Additionally, the experimental group had higher CIXTQ scores for social psychology and visual function, and a lower incidence of visual discomfort symptoms (p < 0.05).CONCLUSION Prism combined with BVT effectively improves visual function and quality of life in IXT patients, demonstrating safety and clinical value.Clinical trial registration https://www.chictr.org.cn/index.html. Clinical Trial Registration Number: ChiCTR2200112320.