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The Newcastle Control Score: A new method of grading the severity of intermittent distance exotropia

Lookup NU author(s): Sarah Richardson, Dr Susan Moloney, Nicholas Strong, Michael Clarke


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Aim: To describe the development and application of a novel scoring system for grading the severity of intermittent distance exotropia (IDEX) and its potential application as an intervention criterion for surgical intervention. Methods: The Newcastle Control Score (NCS) for IDEX was developed by incorporating both subjective (home control) and objective (clinic control) criteria into a scale to grade severity. The score structure described was evaluated for interobserver and test-retest reliability. To determine an optimal score threshold for surgical intervention, 170 cases of IDEX were scored retrospectively. Cure rates for surgical and non-surgical cases were then compared according to preoperative or presenting scores. Results: Interobserver and test-test reliability were good (r = 0.82 and r = 0.89 respectively). Total cure rate with surgery was 54% and without surgery 18% (χ2 = 23.093, df = 1, p<0.001). Significantly fewer patients with NCS ≥3 achieved cure without surgery than those with NCS 2 (χ 2 = 3.362, df = 1, p<0.047). Conclusions: The NCS is a reliable method for grading the severity of IDEX and aids decisions regarding intervention. Patients with a score of 3 or more are unlikely to attain a cure without surgery.

Publication metadata

Author(s): Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP

Publication type: Article

Publication status: Published

Journal: British Journal of Ophthalmology

Year: 2004

Volume: 88

Issue: 2

Pages: 233-235

ISSN (print): 0007-1161

ISSN (electronic): 1468-2079

Publisher: BMJ Publishing Group


DOI: 10.1136/bjo.2003.027615

PubMed id: 14736781


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