Bedside glucose monitoring is only effective if the equipment is accurate, rapid, and reliable. This form of testing is often faster and more cost effective. Laboratory serum glucose testing is the most accurate way of testing blood glucose levels. These specimens are either taken from the heel, arterial, or venous punctures and must be store immediately on ice in order to prevent glycolysis, further altering the results. USA guidelines recommended that the hypoglycemic neonate should have a glucose test every 2–4 hours for the first 24 hours of life. Guidelines in the UK, however, recommend pre-feed screening of at-risk infants at 2–4 hours of age (to avoid false positives when blood glucose is, ordinarily, at its lowest at 2–3 hours of age) and at the subsequent feed until a blood glucose level of  >2.0 mmol/L (36 mg/dL) on at least two consecutive occasions and is feeding well. 1. Medical history
Maternal diabetes mellitus, gestational hypertension, neonatal erythrocytosis, neonatal haemolysis of incompatible blood groups, perinatal asphyxia, severe infection, sclerosis, neonatal respiratory distress syndrome, etc., especially in premature babies, babies younger than gestational age and those who are underfed in the early stages of life are at risk of neonatal hypoglycaemia. 2. Clinical manifestations
Neonatal hypoglycemia should be considered if there are atypical clinical manifestations, if the symptoms improve after glucose infusion, or if there are neurological symptoms and signs that cannot be easily explained. 3. Blood glucose measurement
Postnatal glucose monitoring is the main method of early detection of neonatal hypoglycaemia.
However, he or she may close one eye to compensate for the problem. In children, the reason for not seeing double is that the brain may ignore the image it receives from the squinting eye. This shutting down is known as Suppression. Generally, exotropia progresses in frequency and duration. As the disorder progresses, the eyes start to turn out when looking at close objects as well as those in the distance. If left untreated, the eye may turn out continually, causing a loss of binocular vision or stereopsis. In young children with any form of strabismus, the brain may learn to ignore the misaligned eyes image and see only the image from the best-seeing eye. This is called amblyopia, or lazy eye, and results in a loss of binocular vision, impairing depth perception. In adults who develop strabismus, double vision sometimes occurs because the brain has already been trained to receive images from both eyes and cannot ignore the image from the turned eye. Additionally in adults who have had exotropia since childhood, the brain may adapt to using a "blind-spot", whereby it receives images from both eyes, but no full image from the deviating eye, thus avoiding double vision, and in fact, increasing peripheral vision on the side of the deviating eye. According to a study published in the American Journal of Ophthalmology, over 90 percent of children with intermittent exotropia become nearsighted by the time they’re 20. Causes
The causes of exotropia are not fully understood.