Intermittent exotropia, as the name implies, is a type of exotropia characterized by intermittent and intermittent strabismus. When faced with surgery, parents often have concerns: “We still have time when the eye is not strabismic, can’t we have surgery later?” And the doctor who sees them will say, “If we wait until the child’s strabismus is constant and the eye is squinting at all times before we do surgery, it will be too late.” Why would doctors be in such a hurry to recommend surgery when the strabismus is still intermittent? Intermittent exotropia is an excessive type of strabismus between exotropia and constant exotropia. It can be stable for a long time, or it can be in a state of slow change, which parents can observe in their lives. In some cases, the strabismus is not obvious when it first appears, but appears only occasionally, for example, when you first wake up, when you are tired, when you are unwell, and so on. The strabismus often appears when the child is looking at a distance. The strabismus lasts for a short period of time and often disappears or is controlled by the child as soon as the parent notices it and asks about it. Slowly, the strabismus appears more frequently and often; the duration also gradually lengthens and appears when looking at near places. The parents notice and remind the child that the strabismus cannot be controlled in time either. This is one of the signs that strabismus is worsening and needs to be treated promptly. On the other hand, when the child visits the hospital, there are some relevant tests that can be done to help determine the condition and initially determine the treatment plan. The doctor cannot be with the child every day to observe the condition as the parents do. His understanding of the disease is mainly achieved through strabismus degree and binocular visual function examination. The strabismus test is a more accurate quantitative test of strabismus. Binocular vision function is simply the stereoscopic function of seeing the target with both eyes together, and the examination is mainly to understand whether the child’s advanced visual function has been broken when looking at distance and near. This function directly affects the child’s ability to orient and coordinate, and has an important impact on the child’s professional and occupational choices as an adult. The timing of surgery for intermittent exotropia depends primarily on the size of the strabismus and the disruption of binocular vision. Generally, surgery can be considered when the strabismus exceeds about 25 prism degrees or when the binocular vision function is facing destruction, which gives the child a platform for complete restoration of binocular vision function. If you wait until the degree of strabismus becomes bigger and bigger, the function of seeing far and near completely disappears, and the eyes are often in strabismus, it is a little late to do surgery at this time. Even if the surgery corrects the strabismus, it only improves the aesthetics, and the chance of functional recovery becomes smaller. Therefore, parents are reminded by years of clinical experience that they should not underestimate the seemingly “normal” intermittent exotropia. Once parents find the first signs of strabismus, they should consult the doctor promptly and follow the doctor’s advice to have the surgery as soon as possible to achieve the double cure of appearance and binocular vision.