An otherwise healthy 33-year-old patient presents with left exophoria but no double vision. What is your diagnosis?

Analysis
Here we have an otherwise healthy patient with no past ocular history who presents with left exophoria. Their visual acuity is normal and there are no complaints of double vision. She was orthophoric in all positions of gaze and had full motility of extraocular movements.
This is an example of a patient with a large positive angle Kappa where the pupillary axis does not align with the visual axis, giving the appearance of exotropia.
In this 11-minute video from Dr. Paul Freund, you will review:
- The importance of assessing symptomatology in a patient with strabismus
- Identify the clinical presentation of a patient with large positive angle Kappa
- Understand when a deviations needs to be corrected
Neuro Coach Tip
Strabismus in an asymptomatic patient without double vision does NOT need treatment!
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