PURPOSE: To describe the course of intermittent exotropia (IXT) in children followed without treatment for three years DESIGN: Observation arm from randomized trial of short-term occlusion vs. observation PARTICIPANTS: 183 children 3 to 10 years old with previously untreated IXT and 400 arcsec or better near stereoacuity METHODS: Participants were to receive no treatment unless deterioration criteria were met at a follow-up visit occurring at 3 months, 6 months, or 6-month intervals thereafter for 3 years MAIN OUTCOME MEASURES: The primary outcome was deterioration by 3 years, defined as meeting motor criterion (constant XT ≥10 prism diopters (∆) at distance and near) or near stereoacuity criterion (≥ 2 octaves decrease from best previous measure). For the primary analysis, participants also were counted as deteriorated if treatment was prescribed without meeting either deterioration criterion. RESULTS: The protocol-specified estimate of cumulative probability of deterioration by 3 years was 15% (95% CI = 10% to 22%), but it is likely an overestimate, partly due to misclassification. Among 25 deteriorations, 2 met motor deterioration, 11 met stereoacuity deterioration, and 12 started treatment without meeting either criteria (7 for social concern, 1 for diplopia, 4 for other reasons). Among the 132 participants who completed the 3-year visit and had not been treated during the study, only 1 (
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