Strabismus and employment: the opinion of headhunters

Abstract

. Purpose: The aim of this study was to determine the influence of strabismus on an individual’s ability to find employment based on the opinion of Swiss headhunters. Methods: Forty Swiss headhunters retrieved from a Swiss online telephone directory were interviewed using a validated questionnaire in order to determine if strabismus would have an impact on a person's ability to find employment. Photographs of a strabismic man and woman as well as of other computer‐generated facial anomalies could be downloaded from the Internet during the interview. Results: 72.5% of headhunters judged that strabismic individuals would have more difficulties in finding a job than orthotropic persons. These difficulties were judged to be stronger in women than in men (P = 0.006), and in exotropic compared to esotropic persons (P = 0.01). Asked about seven facial anomalies, exotropia was found to have the third and esotropia the fourth (women) or fifth (men) most strongly negative impact on finding employment, after having strong acne and a visible missing tooth. Headhunters judged that persons with strabismus are significantly perceived as less attractive and less intelligent by potential employers. Conclusion: Visible strabismus negatively influences individuals’ ability to find a job and therefore has an impact on their economic status. Successful strabismus surgery realigns the visual axes, producing a normal facial appearance and therefore eliminating the negative impact of strabismus on employability.

The perception of strabismus by children and adults

“…These results were confirmed by a study of the perception of squinting persons by potential employers [9], where headhunters judged that exotropic individuals would have more difficulties in finding an employment than esotropic ones.…”

“…The squint angles corresponded to 50 prism diopters. These angles were used in the majority of previous studies [2,[9][10][11]. The participants were asked to rank the four photographs of the boy and the four of the girl from the one where the squint is most bothering (rank 1) to the one where it bothers least (rank 4).…”

“…Strabismus is a visible facial abnormality that has been shown to have adverse psychosocial consequences in adults [2,3,[8][9][10][11] and children [12,15].…”

The psychological well-being and appearance concerns of patients presenting with ptosis

“…5 Patients with strabismus, ptosis, or dermatatochalasis were also viewed as less dateable, less attractive, less likeable, and less successful in studies, in which people were asked to rate photographs and headshots of potential dates. 6,7 Difficulties obtaining employment 8,9 and career progression and promotion within the US Army 10 have also been highlighted by the research.…”

We need to pay heed to the psychosocial aspects of strabismus

“…5 These findings were confirmed by headhunters. 6 A new strabismus specific questionnaire was first reported in 2009. 7 The Appearance Scale 20 (AS20) was a patient-derived, health-related quality of life questionnaire for adults with strabismus.…”