Overview

Monocular exotropia is a type of strabismus (eye alignment difference) in which one eye consistently turns outward while the other eye focuses forward. “Monocular” means the same eye is affected rather than alternating between eyes.

This condition can be present from early childhood and may affect how visual information is processed, how depth is perceived, and how comfortable visual tasks feel over time. Monocular exotropia is a visual difference, not a reflection of intelligence, attention, or effort.

How Monocular Exotropia May Present

Monocular exotropia can look different for each individual and may include:

• One eye consistently turning outward

• Difficulty with depth perception or spatial awareness

• Eye fatigue or discomfort, especially during visual tasks

• Closing or covering one eye in bright light or when focusing

• Challenges with tracking, reading, or visual focus

• Sensitivity to visual clutter or busy environments

Some individuals adapt well, while others may require additional visual or environmental supports.

Common Experiences

Individuals with monocular exotropia may experience:

• Visual fatigue after reading or screen use

• Difficulty judging distance or positioning

• Being misunderstood as distracted or unfocused

• Increased effort required for visual tasks

• Frustration when visual demands exceed comfort

Visual differences are not always visible to others, which can make understanding and patience especially important.

Support Looks Different for Everyone

Support for monocular exotropia focuses on visual access, comfort, and reducing strain. Support may include:

• Vision therapy or ophthalmologic care

• Glasses, prisms, or other visual supports when recommended

• Adjusted lighting and reduced visual clutter

• Extra time for reading or visually demanding tasks

• Flexible expectations around eye contact and focus

Support should be responsive to the individual’s needs and comfort level.

For Families & Caregivers

Families and caregivers play an important role in recognizing visual fatigue and advocating for appropriate accommodations. Small adjustments can make a meaningful difference in comfort, confidence, and participation.

Understanding that visual effort may be invisible helps create space for patience and support.

How Infinity Pathways Supports Monocular Exotropia

Infinity Pathways creates resources that help individuals and caregivers share visual needs, preferences, and accommodations across environments.

Our tools are designed to support understanding and reduce assumptions — helping others respond with flexibility and care rather than pressure.

A Note on Language

Some individuals prefer medical terminology, while others prefer more descriptive language when talking about visual differences. At Infinity Pathways, we respect personal preference and center language that honors lived experience.