Successful Treatment of Diplopia With Prism Improves Health-Related Quality of Life

Background: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments. Methods: A systematic search was carried out in the electronic databases of PubMed, Cochrane, Web of Science and PsycINFO. The quality of content and measurement properties of all the disease-specific instruments were assessed using established quality standards. Further, the content of the instruments were examined for comprehensiveness by categorising each item across the eight ophthalmic QoL domains (activity limitation, concerns, emotional well-being, social well-being, economic, convenience, symptoms and mobility). Results: Seventy-one PROMs were identified, out of which 32 were amblyopia-and/or strabismus-specific. Out of all the disease-specific instruments, just four have been subjected to modern psychometric tests and only the adult strabismus questionnaire demonstrated good measurement properties. Most of the amblyopia-specific instruments measured the impact of the treatment of amblyopia on children, while most of the strabismus-specific instruments measured concerns related to appearance and treatment outcome in adults. All instruments have gaps in their content and failed to address QoL comprehensively. Conclusion: All the existing amblyopia-and/or strabismus-specific instruments fall short of desired quality and/or comprehensiveness of content. The review identifies the need for developing an instrument with superior quality and discusses potential directions of future research.Key words: amblyopia, patient reported outcome, quality assessment, quality of life, questionnaire, strabismus Amblyopia and strabismus are common developmental conditions of childhood and are known to cause functional deficits like impaired stereoscopic depth perception and defective sensory, motor, visual cognition and prehension skills.1-3 These functional deficits manifest in the individual as imprecise or inefficient performance of real-life activities like reading, grasping and driving and affect quality of life (QoL). 4,5 Apart from the implications of these functional deficits, socially noticeable strabismus also affects the psychosocial and emotional well-being of individuals. [6][7][8][9][10] Analysis of the cost-effectiveness of screening for amblyopia and its utility are limited by the lack of evidence about the long-term impact, the degree of disability and the impact of amblyopia on QoL. 11-13Incorporating patient-reported outcome measures (PROMs) as one of the treatment outcomes is considered importa...

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“…Adult Strabismus‐20 (AS‐20) questionnaire (Original [n = 24], Adapted [n = 1], Chinese [n = 4], Danish [n = 1])…”

Section: Resultsmentioning

confidence: 99%

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Kumaran

Khadka

Baker

et al. 2018

Clinical and Experimental Optometry

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“…Correction of diplopia with prism is associated with improvement in reading and general function. 15 In the study of Tamhankar et al 72% of patients reported complete or partial resolution of diplopia after prism use for restrictive strabismus. 16 If the deviation is too large to correct with prisms and stable for at least six months, extraocular muscle surgery can be performed.…”

Section: Discussionmentioning

confidence: 97%

Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Kızıltunç¹,

Atilla²

2019

Turkiye Klinikleri J Ophthalmol

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iplopia is a common symptom in ophthalmological and neurological diseases and this symptom affects the quality of life to a great extent. Once the patient is disturbed from diplopia, it must be determined whether diplopia is monocular or binocular. While monocular Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Diplopia is a common symptom in ophthalmologic and neurological diseases. In the presence of binocular diplopia, investigation should be made for differential diagnosis. Detection of the underlying etiology provides early diagnosis of accompanying neurological diseases and facilitates the treatment of diplopia. In this study, we aimed to evaluate the causes of binocular diplopia, treatment modalities and treatment outcomes in a tertiary center. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Medical records of patients with binocular diplopia were reviewed. Demographic features and ophthalmological examination findings were noted. Etiological differential diagnoses of diplopia were elucidated according to the results of full ophthalmological examination and neuro-radiological evaluation with cranio-orbital magnetic resonance imaging. Treatment modalities and responses to these treatments were noted. R Re es su ul lt ts s: : A total of 70 patients were evaluated. Thirty-six patients (51.4%) had cranial nerve palsies. Of 36 patients, 61.1% had 6th nerve palsy, 22.2% 3th nerve palsy and 16.7% 4th nerve palsy. Patients without cranial nerve palsies were also grouped according to the type of deviations. The most common deviations were acute-decompansated esotropia (21.2%) and agerelated esotropia (18.2%). Diplopia recovered in 8 patients (11.4%) after treatment of the underlying etiology. Nineteen (27.1%) patients were not treated due to spontaneous recovery. Prism glasses were prescribed in 22 (31.4%) patients. Twelve patients (17.1%) were operated. Six (8.6%) patients received Botulinum-A toxin injections. C Co on nc cl lu us si io on n: : In the presence of binocular diplopia, cranial nerve palsies should be investigated. Diplopia can resolve spontaneously. In cases with persistant diplopia, prism glasses, Botulinum toxin-A injection and surgery can be performed.

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“…The measurements of this artificially produced diplopia (vergence power) are important in diagnosis and treatment. There are few studies (28,29) evaluating the effects of non-surgical treatments for strabismus on the patient's life quality. Prism correction is a commonly used non-surgical treatment for binocular diplopia in the context of a variety of different strabismus types (30).…”

Section: Nonsurgical Treatment In Diplopiamentioning

confidence: 99%

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

Nicula

Nicula²,

Bulboacă

2019

BALNEO

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One of the most frequent disorders accompanied by diplopia is represented by stroke. Beyond different symptoms of stroke, diplopia constitutes an important clinical factor in influencing the quality of life in surviving patients. In this paper we discuss the visual impairment associated with stroke location, types of diplopia, the clinical examination, and the nonsurgical treatment of diplopia. The purpose of diplopia treatment is to restore binocular vision and eliminate the double vision. The most used nonsurgical treatment for diplopia is the optical correction by the prisms. Another therapeutic option is the botulinum toxin injections. Key words: diplopia, stroke, visual rehabilitation, prism correction,

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Successful Treatment of Diplopia With Prism Improves Health-Related Quality of Life

Cited by 24 publications

References 10 publications

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

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