Purpose: To determine the relationship between intermittent exotropia (IXT) and refractive change and the effects of the methods applied in IXT follow-up on refractive change. Method: The medical records of 228 patients with IXT (group 1) and 110 patients without strabismus (group 2) who were followed between 2008 and 2022 were analyzed retrospectively. Group 1 was divided into three subgroups: overminus correction (group 1A), patients who underwent surgery (group 1B), and patients who were observed (group 1C). Results: Annual myopic progression was −0.21 ± 0.32 D (range, −1.26 to +1.92) in group 1 and −0.07 ± 0.30 D (range, −1.13 to +1.00) in group 2 (P < 0.001). Annual myopic progression was −0.26 ± 0.29 D (range, −1.26 D to +0.12 D) in group 1A, −0.25 ± 0.35 D (range, −1.15 D to +0.25 D) in group 1B, and −0.19 ± 0.33 D (range, −1.12 D to +1.92 D) in group 1C. There was no difference in annual myopic progression between the subgroups (P = 0.670). The annual change in myopic refraction between each of the group 1 subgroups and group 2 was statistically significantly different (P < 0.001, P = 0.023, P < 0.001, resp.). Conclusions: Myopia progression was significantly greater in children with IXT than in the normal population. Myopia progression did not vary with exotropia treatment.