Buck et al reported the Newcastle Control Score for evaluating a patient with intermittent exotropia. This can help guide management for an affected patient. The authors are from the Royal Victoria Infirmary at Newcastle-upon-Tyne in England.
Clinical features of intermittent exotropia:
(1) usually seen in childhood
(2) strabismus is exacerbated by
(2a) fixing on something in the distance
(2b) tiredness
(2c) inattention
(3) in bright sunlight the patient may close one eye
The severity of the exotropia is judged based on observations at home (home control) and in the office using an eye cover test (office control).
Parameters for score:
(1) intermittent exotropia or monocular eye closure (home control)
(2) cover test while viewing something at a distance (office control)
(3) cover test while viewing something nearby (office control)
|
Parameter
|
Finding
|
Points
|
|
intermittent exotropia or monocular eye closure
|
none
|
0
|
|
|
< 50% of time when fixing at something at a distance
|
1
|
|
|
>= 50% of the time when fixing at something at a distance
|
2
|
|
|
>= 50% of the time when fixing at a distance AND present when viewing something nearby
|
3
|
|
cover test, distant object
|
immediate realignment after cover removed
|
0
|
|
|
realignment after refixation or a blinking of the eye
|
1
|
|
|
no realignment
|
2
|
|
cover test, nearby object
|
immediate realignment after cover removed
|
0
|
|
|
realignment after refixation or a blinking of the eye
|
1
|
|
|
no realignment
|
2
|
Newcastle control score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• A score >= 4 was considered to be high.
• The presence of a high score may be an indication for surgery.
