The eye is surrounded with six extraocular muscles (four recti and two oblique muscles). The four recti originate from the annulus of Zinn at the orbital apex to be inserted into the sclera in front of the equator in a spiral fashion called Spiral of Tillaux. The medial rectus insertion is the closest to the limbus while the superior rectus insertion is the furthest. The width of insertion is nearly 10 mm in all recti muscles. Innervations of the recti muscles enter the muscle from the inner side at the junction between the anterior two thirds and the posterior one third of the muscle belly. Exotropia (XT) means the eye is deviated laterally. This may occur all the time (called constant XT) or intermittently (by dissociation of binocular vision by cover test or during periods of illness or fatiguability). Exotropia is mostly multifactorial, however genetic component is present. The clinical management of intermittent exotropia has been discussed extensively in the literature, yet there remains a lack of clarity regarding indications for intervention, the most effective form of treatment and whether or not there is an optimal time in the evolution of the disease at which any treatment should be carried out