Have you or your child been diagnosed with intermittent exotropia?

What Is Intermittent Exotropia?

Intermittent exotropia is a condition where one eye occasionally turns outward, especially when a child is tired, daydreaming, looking at something far away, or not paying close attention. It’s one of the most common types of eye turns (strabismus) seen in children and is often a normal feature of infancy or early childhood that resolves over time.

Many children appear to have normal eye alignment most of the time, but parents may notice the eye drifting out once in a while — this is what we call intermittent exotropia.

Eye Teamwork Is Learned Early

We’re not born knowing how to use both eyes together. Instead, the brain learns to coordinate the eyes and blend the separate images from each eye into one single, clear picture. This process is called sensory fusion, and it begins in the first 12 months of life.

If the brain relies mostly on visual information from one dominant eye and ignores (suppresses) the non-dominant eye, the eyes may drift outward. To improve depth perception and eye coordination, the brain needs to be trained to use both eyes together more consistently.

Signs Parents May Notice

• One eye drifts outward occasionally

• More frequent drifting when child is tired or daydreaming

• Squinting or closing one eye in bright light

• Complaints of double vision (less common in younger kids)

• Trouble with attention or eye strain during near tasks

Treatment Options for Intermittent Exotropia

Not all cases of intermittent exotropia need immediate treatment. Your child’s care plan will depend on the frequency and severity of the eye turn, and how well their eyes are working together.

Mild or infrequent eye turns may only need to be monitored with regular checkups. We may also recommend monitoring children who are under the age of 4 to see if the condition will resolve. Some children will require glasses to help make their vision clearer or support their focusing system. Bifocal lenses are sometimes helpful to reduce visual fatigue.

It’s important to minimize screen time. Focus on developing strong gross and fine motor skills, as these activities support healthy visual development (climbing at the playground, playing catch, coloring, using scissors, building with blocks, and threading beads, etc.).

Vision Therapy

Vision therapy is a structured program of in-office and at-home activities that help the brain and eyes learn to work better together. It can improve eye teaming and coordination, control over the eye turn, depth perception, reading comfort and attention.

What is Vision Therapy?

Vision therapy is a customized program of eye–brain exercises that helps children improve how their eyes work together. It’s designed to train the brain to coordinate both eyes effectively for clear, comfortable, and efficient vision—especially during activities like reading, writing, and paying attention in class. It focuses on strengthening visual skills such as eye coordination, depth perception, tracking, and focusing—skills that are essential for learning and everyday tasks.

What it looks like:

• Weekly office sessions: Typically one hour per week.

• At-home activities: 15–20 minutes of practice per day to support progress.

• Progress checks: Regular evaluations to monitor changes and adjust goals.

• Family support: Parents receive guidance to help reinforce skills at home.

Cost and Insurance: Vision therapy at our office is not usually covered by medical insurance or vision insurance, but our office offers affordable payment plans to make care accessible.

Ready to get started?

If you’re ready to get started with vision therapy, or have any questions, the best way to reach us is by texting our office (253-201-2515)—it’s quick, easy, and our preferred method of communication. You’re also welcome to call or email if you prefer. Please note that we typically have a 2–4 month wait time to begin therapy due to limited availability. Our sessions are offered Tuesday through Friday. We’ll be happy to answer any questions and help reserve a spot for your child as soon as possible!

Do you need treatment for strabismus or amblyopia in the Kent, Auburn, Renton, Covington, Maple Valley, Enumclaw, or Black Diamond area?

Schedule an eye exam today!