Management of a Spectrum of Exotropia Patient with Vision Therapy

Management of a Spectrum of Exotropia Patient with Vision Therapy

with Dr Erin Jenewein



This course will overview the treatment of intermittent and constant exotropia with vision therapy. Tips on how to perform different therapy techniques and how to modify techniques to help improve sensory and motor fusion in exotropia patients will be discussed. Case examples will be presented to highlight key points.

Course Outline 1 hour course

  1. Considerations – Diagnostic evaluation
      1. Is the deviation the same at all distances and fields of gaze?
        1. Basic Exophoria vs. CI vs. DE
      2. How large is the magnitude?
      3. Is the deviation constant or intermittent?
      4. Are there any sensory adaptations?
        1. Suppression
        2. AC
  2. Treating IXT with Vision Therapy – Tricks of the Trade
    1. Diplopia Awareness Training
      1. Why train diplopia awareness?
      2. Where do we begin in the treatment sequence
      3. Diplopia awareness training tips
    2. Sequencing target content
      1. Being with 3rd degree – 2nd degree – 1st degree
    3. Training near to distance
      1. Distance training is important in basic XTs and Des
      2. Review of distance activities
  3. Treating CXT with Vision Therapy – How is it different?
    1. Free space vs. in-instrument
    2. What can we use to help our patient converge in free space?
      1. Minus lenses
      2. Prism
  4. Case Examples


Erin C. Jenewein, OD, MS, FAAO, Diplomate (BVPPO) , Dr. Erin C. Jenewein earned her BSc degree in Biology, Chemistry and Philosophy from St. Norbert College. She completed a Master of Science degree in Biology at the University of Wisconsin.

Dr. Jenewein graduated with highest honors and professional distinction from Nova Southeastern University College of Optometry. Following graduation, she completed a residency at Nova Southeastern University in Pediatrics and Binocular Vision. Dr. Jenewein joined the faculty at Nova Southeastern University College of Optometry and from 2010-2015 served as an Assistant Professor, Chief of Service of The Eye Care Institute at KID, and as part of the faculty of the Master of Science in Clinical Vision Research program. In 2015, Dr. Jenewein joined the Salus University Pennsylvania College of Optometry faculty where she serves as an Assistant Professor and Coordinator for the Binocular Vision Curriculum and Coordinator for the Pediatrics and Vision Therapy Residency.

Dr. Jenewein currently serves as Salus University’s Principal Site Investigator for the multi-centered NEI-funded Pediatric Eye Disease Investigator Group and served as an investigator for the Convergence Insufficiency Treatment Trial Attention and Reading Trial.


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