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New research · Ophthalmology
BMC ophthalmology · 23h
Cohort studyBMC ophthalmology · 2026

Gender-based analysis of visual and refractive characteristics in exotropia.

Masoud Khorrami-Nejad, Mohammad Reza Akbari, Babak Masoomian … Foroozan Narooie-Noori
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OphthalmologyCohort study

Male sex is linked to higher odds of amblyopia in intermittent exotropia.

Gender-based analysis of visual and refractive characteristics in exotropia.

Masoud Khorrami-Nejad … Foroozan Narooie-Noori
BMC ophthalmology · 2026
Purpose

To analyze gender-based differences in visual acuity, refractive error, angle of deviation, and amblyopia in patients with alternate exotropia (Alt XT) and intermittent exotropia (IXT).

Methods

A retrospective study of 4,417 surgical exotropia patients (2,970 Alt XT; 1,447 IXT) compared sex-based differences in CDVA, refraction, deviation angles, and amblyopia within each subtype.

n = 4,417 surgical exotropia patients
Results

males with intermittent exotropia checked more likely to have amblyopia

13%
Males (IXT)
8.7%
Females (IXT)
More results

CDVA and spherical equivalent did not differ by sex in either subtype.

In adjusted models, sex was not associated with right-eye logMAR CDVA in Alt XT (B = 0.005; p = 0.814) or IXT (B = 0.005; p = 0.506).

Sex was associated with a small difference in distance deviation magnitude in Alt XT (B = 1.33 prism diopters; p = 0.018) but not in IXT (p = 0.114).

“
Conclusion · 1 of 3

Gender-specific differences were observed in astigmatism, deviation magnitude, age at surgery, and amblyopia patterns across exotropia subtypes.

Conclusion · 2 of 3

After adjustment, sex remained associated with distance deviation in Alt XT and amblyopia prevalence in IXT, but not with CDVA in either subtype.

Conclusion · 3 of 3

Overall, sex appears to be a relevant clinical variable in exotropia and should be considered in assessment and future research.

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