Why does this child always have “flying eyes”? When is the best time to operate on my child’s strabismus? The number of parents who bring their children to see an eye doctor has increased significantly during the holidays. The other eye looks at the outside of the target, which is usually called “flying eyes” by the people. Experts point out that exotropia can occur at many stages of life. If the onset within six months of birth is congenital exotropia; 2-3 years old onset, to elementary school middle school due to excessive eye aggravation, is the acquired exotropia; there are also adults due to eye trauma, eye tumors and other causes of disuse exotropia. The child’s exotropia is not only unattractive in appearance, but also has a great impact on vision because he or she always looks at things with one eye. In terms of appearance, exotropia affects aesthetics, and over time, this peculiarity often leads to psychological problems such as isolation, low self-esteem and timidity. From the functional point of view, the damage of visual function caused by exotropia is just like a person who cannot walk with two legs or work with two hands, which will cause various difficulties in learning, living and working: the scope of seeing is smaller than normal, there is no ability to integrate images, and there is no stereo vision. In addition to inflammation, injury, B vitamin deficiency or refractive error, fusion insufficiency and amblyopia, there are many other factors that can cause pediatric exotropia. For example, genetic factors, research data show that when both parents have poor vision, refractive error, the child has a high chance of strabismus; artificial feeding and mixed feeding and strabismus occurrence correlation, promote breastfeeding, etc.. More importantly, children’s eyes are too tired nowadays: on the one hand, they are under great pressure and heavy burden of study, besides homework, there are also calligraphy, painting, music, etc. They are exhausted all day long, without much time for activities and rest, and their eyes and bodies are overworked; on the other hand, children look at TV sets, game consoles, computers, etc. for hours, their eyes are sore and swollen, and their eyesight is seriously reduced; in addition, there is a lack of physiological knowledge and health care knowledge about eye health. In addition, the lack of physiological knowledge and health care knowledge in eye care makes children’s eyes “unbearable”, which directly leads to the increase of children with exotropia. Early treatment is the key to prevent pediatric exotropia, and the key is early detection, early diagnosis, and early treatment. The purpose of treatment is not only for cosmetic purposes, but more importantly to improve the visual acuity of the child’s strabismic eye and to increase the chances of obtaining binocular vision. Therefore, treatment should be given as soon as the diagnosis is clear. Usually the main measures are: correction of refractive error, dilated pupil examination and prescription of lenses as appropriate, hopefully with the use of adjustable vergence to help overcome the strabismus. Active treatment of amblyopia to improve binocular vision. The most fundamental means is surgical treatment, which has been clinically proven to be a very good means of resolving strabismus in children. In order to completely eliminate exotropia, surgical correction is often required. Children with stable strabismus, or those who continue to have deviation after non-surgical treatment, and those with alternating gaze should be operated early so as to increase the likelihood of obtaining binocular monocularity or gaining peripheral fusion.