Comment on the Article: Overminus Lens Therapy in the Management of Children with Intermittent Exotropia: Points to Ponder

We read with interest the research article titled “Overminus lens therapy in the management of children with intermittent exotropia” by Abri Aghdam et al.1 There are few issues which we wish to mention regarding this article. The authors aimed to determine the safety and efficacy of overminus lens therapy in children younger than 6 years with intermittent exotropia (X[T]) without mentioning the lower age limit for the inclusion criteria. “For younger children, the senior author ( M.S.S.) decided how many diopters (D) of overcorrecting minus lenses to prescribe without determining the maximum tolerated overminus lens”.1 What is the age by which these younger children defined? This causes the group studied to be nonhomogeneous, since older children have a different criterion for overminus correction. Further, assessment of visual acuity, control, suppression, and measurement of deviation in younger children (<4 years) may not be as reliable as in older ones.