This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haggerty, H Articles by Clarke, M P Search for Related Content PubMed PubMed Citation Articles by Haggerty, H Articles by Clarke, M P

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

¹ Orthoptic Department and Children’s Eye Clinic, Eye Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK
² School of Neurology, Neurobiology and Psychiatry, Faculty of Medicine, University of Newcastle upon Tyne, UK

Correspondence to:
Correspondence to:
Helen Haggerty
Orthoptic Department, Claremont Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; helen.haggerty{at}nuth.northy.nhs.uk

ABSTRACT
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% (² = 23.093, df = 1, p<0.001). Significantly fewer patients with NCS 3 achieved cure without surgery than those with NCS 2 (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.

Keywords: intermittent; exotropia; control; surgery

Abbreviations: BSV, binocular single vision; IDEX, intermittent distance exotropia; NCS, Newcastle Control Score

This article has been cited by other articles:

				D Buck, M P Clarke, H Haggerty, S Hrisos, C Powell, J Sloper, and N P Strong Grading the severity of intermittent distance exotropia: the revised Newcastle Control Score Br. J. Ophthalmol., April 1, 2008; 92(4): 577 - 577. [Full Text] [PDF]

				S R Hatt, H Haggerty, D Buck, W Adams, N P Strong, and M P Clarke Distance stereoacuity in intermittent exotropia Br. J. Ophthalmol., February 1, 2007; 91(2): 219 - 221. [Abstract] [Full Text] [PDF]

				D. Buck, S. R Hatt, H. Haggerty, S. Hrisos, N. P Strong, N. I Steen, and M. P Clarke The use of the Newcastle Control Score in the management of intermittent exotropia Br. J. Ophthalmol., February 1, 2007; 91(2): 215 - 218. [Abstract] [Full Text] [PDF]