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Aims To study the efficacy of using binocular vision training and press-on prism combined therapy for children with exotropia and amblyopia, and to explore the feasibility of binocular visual function recovery and non-operative correction of exotropia in children with exotropia, and the possibility of simultaneous treatment of strabismus amblyopia. Methods Totally 105 Chinese children aged 3–9 years with exotropia and amblyopia were recruited in a randomised clinical trial. Eligible subjects were randomly assigned to the combined group and the prism group, 48 and 57 cases, respectively. The prism group was performed fresnel press-on prisms treatment, the combined group was performed binocular vision training and fresnel press-on prisms treatment. The visual acuity, the binocular function and strabismus therapeutic effect were compared. Results After treatment, the visual acuity in both groups was significantly improved compared with that before treatment, and the difference between the two groups was not statistically significant.The binocular monocular function of the two groups was significantly improved compared with that of the two groups before treatment, including synoptophore visual function and the Titumus stereopsis. The difference between the two groups was statistically significant.In the combined treatment group, 42 patients with strabismus were completely cured with a cure rate of 87.50%, while in the prism group, 16 patients with strabismus were completely cured with a cure rate of 30.19%. The difference between the two groups was statistically significant. The lower the degree of exotropia, the shorter the cure time. Conclusion Binocular vision training and fresnel press-on prisms combined treatment can effectively promote the recovery of binocular vision in children with exotropia combined with amblyopia, and some children can achieve complete cure of strabismus through this non-surgical treatment. In addition, the recovery of binocular vision in children before surgery can improve the cure rate of strabismus surgery.They are basically the same for amblyopia.