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Intermittent exotropia for school vision screening

Your child has been found to have an eye condition called ‘intermittent exotropia’ at their school vision screening test. This is nothing to worry about and we will explain more about this condition in this resource.

What is the school vision screening test?

All children in Sheffield are offered a free eye test at school in reception. This should have been explained in the new starter pack given to you at the start of the school year by the school nursing team (or maybe later if your child started later in the year or has moved schools). Your child will be tested by an orthoptist (an eye specialist who works at the hospital).

Your child will have had their eyesight tested with each eye individually with a letter-matching test. Children get to practise their test before they start. Your child will have then been checked for:

  • a squint (an eye condition where one or both eyes turn in different direction from the other)
  • any eye movement problems
  • the ability for the eyes to work together and see in 3D

All children are offered a sticker and we do not share the results of the eye test with the child or their teacher.

What is an intermittent exotropia?

An exotropia is an eye muscle condition where one or both of the eyes (not both at the same time) can drift outwards to the side. It is not painful and generally young children are unaware that this is happening. An intermittent exotropia is where the eye drifts to the side only occasionally — you may have noticed this in your child’s eyes before. The most common times to see the eye drifting outwards are:

  • when your child looks at something very far away
  • when your child looks up or to the side
  • if your child is tired, not well or not focusing on anything in particular (day dreaming)
  • if your child is outside in bright sunshine

Here is a picture of what an exotropia can look like:

Illustration of child with one eye looking another way

Is my child’s eyesight normal?

Yes. If your child did not have normal eyesight or if we were unable to test your child accurately enough to prove normal eyesight we would call you to discuss this and to arrange another eye test. Children with an intermittent exotropia usually develop good eyesight in each eye as the eyes work together normally for most of the time.

What symptoms do I need to look for?

Many people who have an intermittent exotropia don’t have any symptoms or problems with their eyes and do not need any eye treatment. We would advise your child has another eye test if you notice any of the following symptoms:

  • seeing an eye drift to the side more frequently
  • closing or frequently rubbing one eye
  • complaining of double vision (seeing 2 of the same thing at the same time)
  • frequent headaches
  • complaining of not seeing very well or if you notice a change in what your child can see

What happens next?

If you have no concerns about your child’s eyes you do not need to do anything.

If you would like your child to have another eye test at the Eye Department at the hospital then we can arrange this for you. Your child would have the same tests done as at their school vision screening eye test with you or a family member present. Your child would then have drops put into their eyes to make their pupil (the black circle in the middle of the eye) larger so an optician can check the health of the eye and perform a glasses test. If no treatment is needed your child will be discharged. If you would like this to be arranged you can call the Sheffield School Vision Screening Service on 0114 305 3060.

If you would like your child to have an eye test at a later date or notice a change in your child’s eyes or vision in the future, you can take them to any high street opticians for an eye test. All children aged 16 and under are entitled to a free eye test at all opticians. Alternatively, you can see your GP. If your child needs further eye testing by an eye specialist then the optician or GP can refer your child to the hospital. If glasses are needed, the optician can supply these to you directly.

If you would like to talk to someone about the school vision screening test or have any further questions please call the Sheffield School Vision Screening Service on 0114 305 3060.

Contact us

Vision screening team telephone number: 0114 305 3060

Eye department secretaries at Sheffield Children’s NHS Foundation Trust: 0114 271 7468

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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