Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties?

Mojon-Azzi, Stefania M.; Kunz, Andrea; Mojon, Daniel S.

doi:10.1136/bjo.2010.185793

Cited by 58 publications

(42 citation statements)

References 21 publications

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“…This implies that we should comprehensively consider patient self-esteem and psychosocial characteristics during treatment to obtain better satisfaction and quality of life. As Granet suggested, it is reasonable to conclude that some patients find that obtaining a normal appearance is more important due to social responses to strabismus[33], and physical characteristics should be given the same value as functional characteristics in strabismus treatment[34]. …”

Section: Discussionmentioning

confidence: 99%

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Chen

et al. 2016

PLoS ONE

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PurposeTo evaluate the status of and factors associated with long-term health-related quality of life (HRQOL) in adult patients with strabismus following corrective surgery.MethodsProspective cross-sectional study. A total of 122 adults who underwent corrective surgery and were followed up for at least 1 year were recruited. Pre- and post-operative HRQOL were evaluated using the Chinese version of the Adult Strabismus 20 (AS-20). Demographics and clinical characteristics were recorded. Eighty-nine age-matched, normal individuals without a history of strabismus were recruited as a control group.ResultsAS-20 scores improved significantly in the psychosocial subscale and total scale after surgery for all122 patients, but not in the function subscale. HRQOL was better in the successful cases than in the non-successful cases (p<0.005). Subjects who recovered stereo function had better HRQOL than those who did not (p<0.01). Compared to the control population, the patients had poorer HRQOL post-operatively, with only approximately 30% of the subjects having scores within the normal threshold scores. The self-sense of a lack of ocular deviation and a successful surgical outcome were significant factors associated with post-operative HRQOL status.ConclusionsHRQOL, as evaluated by AS-20 scores, improved in the patients after surgery but was worse than that in the general population. Successful surgical outcomes and a sense of good alignment were the main factors that correlated with increased post-operative HRQOL. Positive assessments of surgical results by patients may benefit post-operative HRQOL.

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Section: Discussionmentioning

confidence: 99%

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Chen

et al. 2016

PLoS ONE

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“…Similarly in young children, squint has been linked to lower psychosocial functioning, poorer interpersonal relationships and lower self-esteem [15,16]. It has been shown that children as young as 5 years are significantly more likely to have negative social reactions to peers with strabismus [13,14] and that teachers rate photographs of children with strabismus more negatively than those with straight eyes [15]. …”

Section: Introductionmentioning

confidence: 99%

Surgery versus Active Monitoring in Intermittent Exotropia (SamExo): study protocol for a pilot randomised controlled trial

Buck

McColl

Powell

et al. 2012

Trials

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BackgroundChildhood intermittent exotropia [X(T)] is a type of strabismus (squint) in which one eye deviates outward at times, usually when the child is tired. It may progress to a permanent squint, loss of stereovision and/or amblyopia (reduced vision). Treatment options for X(T) include eye patches, glasses, surgery and active monitoring. There is no consensus regarding how this condition should be managed, and even when surgery is the preferred option clinicians disagree as to the optimal timing. Reports on the natural history of X(T) are limited, and there is no randomised controlled trial (RCT) evidence on the effectiveness or efficiency of surgery compared with active monitoring. The SamExo (Surgery versus Active Monitoring in Intermittent Exotropia) pilot study has been designed to test the feasibility of such a trial in the UK.MethodsDesign: an external pilot patient randomised controlled trial.Setting: four UK secondary ophthalmology care facilities at Newcastle NHS Hospitals Foundation Trust, Sunderland Eye Infirmary, Moorfields Eye Hospital and York NHS Trust.Participants: children aged between 6 months and 16 years referred with suspected and subsequently diagnosed X(T). Recruitment target is a total of 144 children over a 9-month period, with 120 retained by 9-month outcome visit.Randomisation: permuted blocks stratified by collaborating centre, age and severity of X(T).Interventions: initial clinical assessment; randomisation (eye muscle surgery or active monitoring); 3-, 6- and 9-month (primary outcome) clinical assessments; participant/proxy completed questionnaire covering time and travel costs, health services use and quality of life (Intermittent Exotropia Questionnaire); qualitative interviews with parents to establish reasons for agreeing or declining participation in the pilot trial.Outcomes: recruitment and retention rates; nature and extent of participation bias; nature and extent of biases arising from crossover or loss to follow-up; reasons for agreeing/declining participation; variability of cure rates (to inform power calculations for a definitive RCT); completion rates of outcome measures.DiscussionThe SamExo pilot trial will provide important pointers regarding the feasibility of a full RCT of immediate surgery versus deferred surgery/active monitoring. The results of this pilot, including differences in cure rates, will inform the design of a definitive RCT.Trial registrationISRCTN44114892

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“…Difficulties with self‐image, securing employment, interpersonal relationships, school, work, and sports were first documented in 1993 in the report of a case–control study of strabismus patients older than 15 years . Since that time, many experimental and observational studies have documented the psychosocial disadvantages for both children and for adults with manifest strabismus, identifying that strabismus and its non‐surgical treatments (patches or spectacles) rendered children less socially acceptable, particularly by other children aged 6 years or more . Social acceptance and inclusion are central to the concept of participation, a factor that is believed to be an important determinant of quality of life, perhaps particularly in children .…”

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confidence: 99%

Strabismus, a preventable barrier to social participation: a short report

Blair

Smithers‐Sheedy

2016

Develop Med Child Neuro

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Isolated strabismus does not significantly impair visual functionality and has traditionally been considered a primarily cosmetic defect of little importance. However, even in the absence of strabismus amblyopia, manifest strabismus and its non‐surgical treatments can render the person less socially acceptable, creating a barrier to participation and resulting in psychosocial disadvantage that has been documented in the typically developing population. The Australian Cerebral Palsy Register traditionally recorded strabismus only if it were not accompanied by visual impairment; however, even these data indicate that the proportion of cerebral palsy registrants with strabismus is many times higher than in comparable population samples, compounding their challenges to achieve participation. It is therefore inappropriate to continue to consider strabismus as merely a cosmetic defect, but one that deserves surgical correction early in life.

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Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties?

Cited by 58 publications

References 21 publications

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Surgery versus Active Monitoring in Intermittent Exotropia (SamExo): study protocol for a pilot randomised controlled trial

Strabismus, a preventable barrier to social participation: a short report

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