____________ XT is iatrogenic in nature and is often secondary to an over-correction of an esotropia during strabismic surgery.

• A. Consecutive XT
• B. Infantile XT
• C. Micro ET
• D. Sensory ET

Answer: (A)

Consecutive exotropia is an iatrogenic outward misalignment that occurs after surgery intended to correct esotropia. It happens when the surgical correction overdoes the inward turn, shifting the balance toward abduction. Practically, this means the medial rectus may have been recessed too much or the lateral rectus not strengthened enough, so the eyes drift outward rather than stay aligned. This differs from infantile exotropia, which presents early in life and isn’t caused by surgical overcorrection; micro exotropia, which is a small-angle exotropia, and sensory exotropia, which stems from vision loss in one eye leading to suppression and misalignment rather than a surgical overshoot. In consequence, the best understanding is that a post-op exotropia like this flags an overshoot in the prior procedure and guides consideration of rebalancing the ocular muscles if needed.