> Source: https://www.thenycoptometrist.com/blog/looking-up-trend-eye-alignment-exotropia-nyc (last updated 2026-10-06) # The "Looking Up" TikTok Trend and What It Might Reveal About Your Eye Alignment **By Dr. Joanna Latek** ยท Published 2026-10-06 > A viral trend has people filming their eyes as they look up, and some are noticing their eyes drift apart. Here's what that can actually mean, and why intermittent exotropia is worth a real diagnosis, not just a comment section. There's a trend going around where people film themselves looking straight up at the ceiling, then post the clip, sometimes captioned with surprise or concern: their eyes drift outward and apart when they do it. The comment sections fill up with people testing it on themselves and reacting the same way. It's a strange, oddly compelling piece of internet eye content, and it's also, unintentionally, surfacing a real clinical sign that eye doctors actually look for. ## What's likely happening When both eyes drift outward together, especially in a specific gaze position like straight up, it's often a form of exotropia, an outward misalignment of the eyes. A subtype called V-pattern exotropia shows almost no misalignment in downgaze but a noticeable outward drift in upgaze, which lines up closely with what people are filming in this trend. More broadly, many people are likely demonstrating intermittent exotropia, the most common form of childhood-onset strabismus, which doesn't always show up constantly; it tends to appear during fatigue, illness, distance viewing, or specific gaze positions, and can be controlled \(pulled back into alignment\) by the brain the rest of the time. That's exactly why someone can go their whole life without realizing their eyes drift, until a phone camera catches a specific moment their control breaks down. This is a genuinely common condition. It's also one where refractive error plays a real role: a 2024 systematic review and meta-analysis published in _Health Science Reports_, which pooled 23 studies on the topic, found a significant association between uncorrected or under-corrected refractive error and intermittent exotropia, reinforcing that an accurate glasses prescription is part of managing this condition, not a side note to it. ## Why it's worth more than a passing "huh, weird" Eye drift that shows up only in certain conditions is easy to write off, because most of the time it isn't visible and doesn't cause obvious problems. But intermittent exotropia isn't purely cosmetic. When binocular control is inconsistent, it can affect depth perception, contribute to eye strain or headaches, and in some cases cause intermittent double vision, especially with fatigue or when looking at distant objects. It's also a condition that tends to change over time, not stay static. A 2026 real-world cohort study following 415 patients with intermittent exotropia over more than a decade, published in _Medicina_, found that without treatment, alignment tends to decline progressively: cumulative alignment stability dropped from about 90% at one year to roughly 30% at ten years in their cohort, while surgical treatment, when appropriate, was strongly protective against that decline. In other words, this isn't a condition where "wait and see" is automatically the safest choice; the right next step depends on the severity and trajectory, which is exactly what a comprehensive exam is for. ## What an actual evaluation involves If you tried the trend and noticed a real drift \(not just a subtle asymmetry, but eyes visibly moving apart\), it's worth a comprehensive eye exam that includes a binocular vision assessment, not just a vision chart. That typically includes checking your eye alignment at distance and near, in different gaze positions, testing how well your eyes work together \(stereopsis and fusion\), and getting an accurate refraction, since an uncorrected prescription can worsen the drift. Depending on what we find, management can range from glasses alone, to vision therapy to improve binocular control, to surgical correction of the eye muscles in more significant or progressive cases. None of that is decided from a phone video; it comes from an actual exam. ## Thinking about your eye alignment? I see patients at Eye & Health in the East Village, and a binocular vision evaluation is part of a standard comprehensive exam here. If a viral trend \(or anything else\) has you wondering about your eye alignment, that's a good reason to come in. You can book online, usually within the week. _This is not medical advice. Please consult your eyecare professional or schedule an eye appointment today._ --- ### Tags - `binocular-vision` - `trending` - `eye-exams` --- ### Bibliography Mohammad, Najah K., et al. "Exploring the Link: A Systematic Review and Meta-Analysis on the Prevalence and Association Between Refractive Errors and Intermittent Exotropia." Health Science Reports, vol. 7, 2024. Guvenc, Umay, et al. "Long-Term Outcomes of Intermittent Exotropia: A Real-World Longitudinal Cohort Study of 415 Patients." Medicina, vol. 62, no. 3, 2026, article 481.