Abstract: Intermittent exotropia (IXT) is progressive and can damage binocular vision and develop into constant exotropia. Currently, surgery is the main treatment method for IXT, which can significantly improve appearance and visual function, but there are risks such as overcorrection, undercorrection, and recurrence. Non-surgical treatments (e.g., occlusion, negative lens overcorrection, and visual training) are non-invasive and have fewer side effects, which can relieve symptoms and improve visual function, but some patients have poor compliance and inconsistent therapeutic effects. At present, due to the lack of high-quality evidence and in-depth understanding of the natural course of the disease, there is no consensus in clinical practice on core issues such as the optimal intervention time, treatment plan selection, and evaluation criteria for IXT. This review aims to systematically summarize the progress in the treatment of IXT (e.g., the selection of surgical methods and the effects of non-surgical interventions), and discuss the current clinical challenges and future research directions, with the aim of providing a reference for clinical decision-making.

Key words: Intermittent exotropia, Visual training