Title: The impact of strabismus on psychosocial health and quality of life

Abstract

Introduction: Strabismus or ocular misalignment is derived from the Greek word strabismos, “to squint or look obliquely.” Common causes of strabismus include abnormalities of binocular vision and anomalies of neuromuscular control of ocular motility. Strabismus disrupts visual development, negatively affects overall health, and often results in psychological distress. Objectives: This systematic review evaluates the impact strabismus has on health and quality of life in children and adults. The review also examines challenges encountered by parents of children with strabismus. Scope: Strabismus is a public health concern. It frequently causes irreversible vision loss in children and increases injury risk in mature adults. This study reports misconceptions towards individuals with strabismus and the impact strabismus has on overall health, psychosocial health, and quality of life. Methods: A systematic literature search was completed using the major terms strabismus, psychosocial health, quality of life, negative attitudes and misconceptions, strabismus treatment, prematurity, children, and adults with varying combinations, medical subject headings (MeSH), and Booleans. The electronic databases searched were Embase, Medline (Ovid) from 1946 to present, PsycINFO (from 1806 to present), PubMed (from inception to present), and Scopus. No date or language restrictions were applied. Results: One hundred fifty-seven articles were included. Strabismus related health problems hinder daily function and negatively impact well being. Persistent negative attitudes towards those with strabismus contribute to difficulties with self-image. Adults with strabismus often experience financial difficulties. Misinformation regarding available treatment options limit access to care. Improved education of health care providers can increase appropriate referrals and initiation of treatment. Treatment of strabismus has the potential to improve overall health, psychosocial health, and quality of life for children and adults with and without diplopia. Conclusions: Strabismus surgery should be considered reconstructive, not cosmetic. Strabismus treatment has the potential to improve multiple aspects of an affected individual’s life.