My ds was very much like this at 2 and 3. Had to get all the Cheerios in the bowl in a perfect circle. Had to line up his toys just so at the foot of his bed (one night we put a toy in that he always had at the end of his bed but we put it facing left instead of right, and wow, it was nearly the end of the world). He named his feet and insisted that I not only call him to the table or told him to get ready, I had to call his feet by their names, too, in the right order (left foot first, always).
It turns out he's just a really precise and intelligent person. Now he's in his late 20s, is an audio engineer and systems technician, graduated from a very demanding college with honors, and his precision with the complicated microphones, sound boards, repairs, set-ups, and his abilities to mix sound at live events around the world, are highly respected among his colleagues.
I think the best way to handle this is to evaluate whether the child is capable of doing normal things, just in an exacting way. If the child is able to go to the store or on an errand or to the park with a friend and friend's mom, or go to grandma's house for an evening of babysitting, or go to a Sunday School class or to a pre-school or daycare, with few difficulties (even if the shoes must be tied in a particular way), that's good. If the child can sleep in his own bed without mom or dad spending a couple hours lying down next to him, even if the blanket must be just so and the same pajamas worn night after nigh, that's good. If the child can play alone, even if all the red blocks have to be separate from the yellow ones, that's good. If the child can eat the meal that's served, even if the green beans have to be lined up like soldiers, that's good.
But if the child can't participate in age-appropriate activities, can't function even for a moment, can't eat anything except one or two foods over and over and over, and if the exact-ness means that the child is unable to do what is normally expected of a child of his age and abilities, then perhaps the precision and demanding exact-ness is getting in the way of life and should be addressed.
Most kids who are this exact and this in control of their environment usually learn how to balance the control and the unexpected stuff that happens during the day. At a very young age, they just know they want things "just so", and haven't developed the maturity to find that balance. Make sure you demonstrate calm, patience, and most of all, a healthy way to approach an unexpected problem. If you have one egg left, and you need it for the cake you're making, and you accidentally drop the egg, make sure your son sees you say "well, I think I'll make something else then" instead of panicking. If you verbally demonstrate to your son how to handle life's situations that we have no control over, he'll gradually learn that skill of controlling what you must, and rolling with the stuff that you can't control.
