Exotropic Mobius Syndrome: Report of Three Cases and Literature Review

To describe three cases of exotropic Mobius syndrome and to report outcomes of the surgical intervention.
Case Reports: Three patients including two boys and one girl were referred to our strabismus clinic. All had masked faces and non-progressive congenital bilateral facial palsy and dry eye. Other abnormalities included large angle exotropia and bilateral horizontal gaze palsy. Surgical interventions, which were performed in the first two cases, included bilateral lateral rectus disinsertion followed by bimedial rectus resection in two separate sessions. Occlusion of the puncti and tarsorrhaphy were performed to treat dry eye. Strabismus surgery led to orthotropia with no change in gaze limitations. The third patient declined surgical intervention.
The two-step surgical intervention including bilateral lateral rectus disinsertion followed by bimedial rectus resection can effectively treat strabismus in exotropic Mobius syndrome. Dry eye symptoms which are common in this type of Mobius syndrome require special attention.