A 44-year-old male presents with a history of exotropia of the left eye since birth. His only other ocular history is myopia for which he wears glasses (-2.50 OU). He has no history of prior eye surgery and is in good health, with no significant past medical history. On examination, his corrected acuity is 20/25 (6/7.5) right and 20/40 (6/12) left. On examination, you notice that he adopts a face turn to the right of approximately 20 degrees when fixating on objects. With this anomalous head posture, his exotropia measures 35 prism diopters (PD) with distance fixation and 25 PD with near fixation. When forced into the primary position, his exotropia is larger, measuring more than 50 PD with distance fixation and 45 PD with near fixation.