26M — Right eye diagnosis shifted from exotropia to microtropia in 8 months, post-corneal transplant. Anyone been through this?
History: bilateral keratoconus — left eye had full corneal transplant (2020), right eye had partial transplant/DALK (2019) + cataract surgery (2021). Right eye vision has always lagged behind the left.
Two orthoptic assessments, 8 months apart:
**• Jan 2026:** VA 6/18 (R) / 6/9 (L). Alternating exotropia, diagnosed as intermittent distance exotropia. Plan: glasses + home vision therapy.
**• Aug 2026:** Same VA, but deviation now 12–16 prism diopters, and eccentric fixation appeared in both eyes (wasn’t there before). Diagnosis changed to right microtropia with poor right vision. Plan: continue glasses, add vision therapy, review in 2 months.
Anyone had a diagnosis shift like this — from bigger intermittent exotropia to microtropia? Does new eccentric fixation in both eyes mean it’s getting worse, or just a more refined diagnosis? Also curious if vision therapy actually helped anyone regain fixation as an adult, or if surgery ends up being the more likely path.
Not replacing my doctor’s advice, just want other perspectives.
u/Vast_Emphasis7594 — 10 days ago