{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T01:23:40Z","timestamp":1762651420307,"version":"build-2065373602"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>True divergence excess, a subtype of intermittent exotropia, presents with a greater exodeviation at distance than at nearby. Its management often requires tailored surgical strategies to address both distance and near deviations. A 9-year-old Saudi girl presented with intermittent right-eye exotropia. Prism and alternate cover test measurements revealed 30 prism diopters (PD) of exodeviation at distance and 12 PD at nearby. Cycloplegic refraction showed mild hyperopia. The accommodative convergence to accommodation ratio was within normal limits. No significant ocular or systemic comorbidities were present. The patient underwent bilateral lateral rectus recession (7\u00a0mm) to correct the distance deviation, combined with bilateral medial rectus Faden procedures to control near deviation. The surgery proceeded without complication. On postoperative Day 1, the patient achieved orthophoria at both distance and near. At the 3- and 6-month follow-ups, ocular alignment remained stable, with only a mild residual exotropia of 5 PD at distance without glasses. No diplopia or motility restrictions were reported. A combined surgical approach of bilateral lateral rectus recession and medial rectus Faden procedure can effectively manage true divergence excess in intermittent exotropia, yielding stable postoperative alignment. Individualized surgical planning remains essential for optimizing outcomes.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf868","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T01:20:47Z","timestamp":1762651247000},"source":"Crossref","is-referenced-by-count":0,"title":["Combined bilateral lateral rectus recession and medial rectus Faden procedure in true divergence excess exotropia: a case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8617-6089","authenticated-orcid":false,"given":"Ahmed","family":"Swelam","sequence":"first","affiliation":[{"name":"Pediatric Ophthalmology & Squint Unit , Magrabi Eye Center \u2013 Prince Sultan Street, North Jeddah 23437, Makkah ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled AbdelKhalique abdelshafi","family":"Ghaith","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, King Fahad Hospital, Al Baha Health Cluster , Abad Algadaae Street, Al Baha 65527 ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Hegab","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Faculty of Medicine, Cairo University , 84 Wadi ElNile Street, Al Zaiton, Cairo 11734 ,","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherin","family":"Ghaith","sequence":"additional","affiliation":[{"name":"Al Baha Health Cluster , Ashetebah, Baljurishi, Al Baha 65652 ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-5532","authenticated-orcid":false,"given":"Abdulmajeed","family":"Al khathami","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, King Fahad Hospital, Al Baha Health Cluster , Abad Algadaae Street, Al Baha 65527 ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selma","family":"Milisic","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Public Institution Health Center of Sarajevo Canton , Vrazova 11, Sarajevo 71000 ,","place":["Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"2025110820204040500_ref1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1080\/09273972.2016.1242640","article-title":"Symptoms in children with intermittent exotropia and their impact on health-related quality of life","volume":"24","author":"Hatt","year":"2016","journal-title":"Strabismus"},{"key":"2025110820204040500_ref2","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1097\/00006324-199205000-00008","article-title":"Treatment options in intermittent exotropia: a critical 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