Prevalence and Management of Divergence Excess

The prevalence of divergence excess was assessed from the records of 250 consecutive patients attending a binocular-vision clinic. The 67 cases in the sample showing divergence excess were subdivided into the following groups: (1) secondary to operations for esotropia (8 cases); (2) anisometropic amblyopes (14 cases); (3) basic (14 cases); (4) convergence weakness (13 cases); (5) divergence excess (18 cases). Treatment methods placed heavy emphasis on physiological diplopia. Of the 18 in the divergence excess category, 14 began treatment, 10 showed a satisfactory outcome, two achieved some improvement, and two discontinued treatment on their own. Divergence excess seems to respond well to nonsurgical treatment.